Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight
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To evaluate the effects of maternal pre-pregnancy body mass index (pre-BMI) and gestational weight gain (GWG) on neonatal birth weight (NBW) in the population of Chinese healthy pregnant women, attempting to guide weight control in pregnancy. A retrospective cohort study of 3772 Chinese women was conducted. The population was stratified by maternal pre-BMI categories as underweight (<18.5 kg/m2), normal weight (18.5–23.9 kg/m2), overweight (24.0–27.9 kg/m2), and obesity (≥28.0 kg/m2). The NBW differences were tested among the four groups, and then deeper associations among maternal pre-BMI, GWG, and NBW were investigated by multivariate analysis. NBW increased significantly with the increase of maternal pre-BMI level (P<0.05), except overweight to obesity (P>0.05). The multivariate analysis showed that both pre-BMI and GWG were positively correlated with NBW (P<0.05). Compared with normal pre-BMI, underweight predicted an increased odds ratio of small-for-gestational-age (SGA) and decreased odds ratio for macrosomia and large-for-gestational-age (LGA), and the results were opposite for overweight. With the increase of GWG, the risk of SGA decreased and the risks of macrosomia and LGA increased. In addition, in different pre-BMI categories, the effects of weight gain in the first trimester on NBW were different (P<0.05). NBW is positively affected by both maternal pre-BMI and GWG, extreme pre-BMI and GWG are both associated with increased risks of abnormal birth weight, and maternal pre-BMI may modify the effect of weight gain in each trimester on NBW. A valid GWG guideline for Chinese women is an urgent requirement, whereas existing recommendations seem to be not very suitable for the Chinese.
Key wordsPre-pregnancy body mass index Gestational weight gain Neonatal birth weight Appropriate weight gain pattern
本文做了一个样本为3772 例中国孕妇的回顾性研究。根据孕前体质量指数将人群分为四组,分别为低体重组(<18.5 kg/m2)、正常体重组(18.5–23.9 kg/m2)、超重组(24.0–27.9 kg/m2)和肥胖组(≥28.0 kg/m2)。比较这四组间新生儿出生体重的差异,并用多元分析的方法探究孕前体质量指数、孕期增重和新生儿出生体重之间的关系。
关键词孕前体质量指数 孕期增重 新生儿出生体重 合理的增重方式
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Thanks are due to Ninghai Maternity and Child Health Care Hospital, Ningbo, China for making all the clinical data available to us.
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