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Cambio de peso entre embarazos y riesgo de resultados adversos del embarazo: un estudio poblacional
Eduardo Villamor1, Sven Cnattingius
1Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. evillamo@hsph.harvard.edu
Lancet (London, England)
|October 3, 2006
Resumen
El aumento de peso entre embarazos aumenta los riesgos de resultados adversos como la preeclampsia y la diabetes gestacional. Incluso los aumentos modestos en el índice de masa corporal (IMC) pueden provocar complicaciones, lo que resalta la necesidad de controlar el peso antes del embarazo.
Área de la Ciencia:
- Epidemiología de la reproducción.
- Medicina materna y fetal.
- Salud pública La salud pública.
Sus antecedentes:
- La obesidad materna está relacionada con resultados adversos del embarazo, pero la evidencia causal es limitada.
- Investigar los cambios temporales de peso puede aclarar la relación causal entre el peso materno y los riesgos del embarazo.
Objetivo del estudio:
- Examinar la asociación entre los cambios en el índice de masa corporal (IMC) antes del embarazo entre embarazos consecutivos y el riesgo de resultados adversos en el segundo embarazo.
- Proporcionar evidencia que respalde las intervenciones de control de peso para las mujeres que planean un embarazo.
Principales métodos:
- Estudio sueco a nivel nacional de 151.025 mujeres con dos partos singleton consecutivos (1992-2001).
- Análisis del cambio del IMC antes del embarazo desde el primer embarazo hasta el segundo.
- Relaciones de probabilidades ajustadas calculadas para varios resultados adversos del embarazo.
Principales resultados:
- El aumento de 3+ unidades de IMC entre embarazos aumentó significativamente los riesgos: preeclampsia (1.78), hipertensión gestacional (1.76), diabetes gestacional (2.09), parto por cesárea (1.32), muerte fetal (1.63) y nacimiento grande para la edad gestacional (1.87).
- Las asociaciones mostraron una relación lineal con la cantidad de cambio de peso.
- Los riesgos fueron elevados incluso en mujeres con un IMC inicialmente saludable que aumentaron de peso.
Conclusiones:
- Los hallazgos apoyan un vínculo causal entre el sobrepeso/obesidad y los resultados adversos del embarazo.
- Un aumento modesto del IMC antes del embarazo puede causar complicaciones perinatales, incluso sin tener sobrepeso.
- La evidencia sólida apoya la defensa de la pérdida de peso para las mujeres con sobrepeso / obesidad y la prevención del aumento de peso en las mujeres de peso saludable que planean el embarazo.
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