Pre-pregnancy body mass index and gestational weight gain in Thai pregnant women as risks for low birth weight and macrosomia

泰国孕妇孕前体质指数和孕期增重是低出生体重和巨大儿发生的危险因素

Tippawan Pongcharoen ； Sueppong Gowachirapant ； Purisa Wecharak ； Natnaree Sangket ； Pattanee Winichagoon

《Asia Pacific Journal of Clinical Nutrition》 25卷4期 (2016/12) Pp. 810-817

https://doi.org/10.6133/apjcn.092015.41

摘要

背景与研究目的：产妇怀孕前的体质指数（BMI）和孕期增重（GWG）与妊娠结局有关已被报道。泰国由于营养过渡，营养不良的双重负担不断增加，这可能会对妊娠结局产生负面影响。本研究旨在探讨孕前BMI 和GWG 与低出生体重和巨大儿发生风险的关系。方法与研究设计：我们对轻度碘缺乏的泰国孕妇进行碘补充试验的资料进行了二次分析。根据WHO 的标准，对孕前BMI 进行分类，根据IOM 推荐的标准对GWG 进行分类。进行二分类和多项无序分类logistic 回归分析。结果：378 名孕妇中，怀孕前低体重（BMI＜18.5 kg/m^2）和超重（BMI≥25 kg/m^2）的发生率分别为17.2%和14.3%。与超重女性 [13.2（9.0，16.3）kg] 相比，正常体重女性的GWG 的中位数最高 [15.0（12.0，19.0）kg]。41%的女性GWG 过多，而23%的女性GWG 不足。孕前BMI 高的孕妇生产巨大儿的风险增加7 倍。GWG 过多的孕妇生产巨大儿的风险增加8 倍。结论：孕前体重高和孕期体重过度增加均增加巨大儿的发生风险。因此，应推荐在孕前和整个孕期均保持正常体重，以降低婴儿出生体重过重及其相关并发症的风险。

關鍵字

孕前体质指数 ； 孕期增重 ； 低出生体重 ； 巨大儿 ； 孕妇

並列摘要

Background and Objectives: Maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) have been reported to be associated with pregnancy outcomes. Due to the nutrition transition in Thailand, the double burden of malnutrition is increasing and this may have negative consequences on birth outcomes. This study aimed to investigate the relationship between pre-pregnancy BMI and GWG with the risks of low birth weight and macrosomia. Methods and Study Design: We performed a secondary analysis of data obtained from an iodine supplementation trial in mildly iodine-deficient Thai pregnant women. Pre-pregnancy BMI was classified using the WHO classification. GWG was categorized using the IOM recommendation. Binary and multinomial logistic regressions were performed. Results: Among 378 pregnant women, the prevalence of pre-pregnancy underweight (BMI＜18.5 kg/m^2) and overweight (BMI≥25 kg/m^2) were 17.2% and 14.3%, respectively. Normal weight women had the highest median GWG [15.0 (12.0, 19.0) kg] when compared to overweight women [13.2 (9.0, 16.3) kg]. Forty-one percent of women had excessive GWG, while 23% of women gained weight inadequately. Women with a high pre-pregnancy BMI had a 7-fold higher risk of having a macrosomic infant. Women who had excessive GWG were 8 times more likely to deliver a newborn with macrosomia. Conclusions: Both high pre-pregnancy maternal weight and excessive weight gain during pregnancy increase risk of infant macrosomia. Therefore, maintaining normal body weight before and throughout pregnancy should be recommended in order to reduce the risk of excessive infant birth weight and its associated complications.

並列關鍵字

pre-pregnancy body mass index ； gestational weight gain ； low birth weight ； macrosomia ； pregnant women