重新思考关于母亲的BMI,妊娠期体重增加和不良怀孕结果的因果假设
Jodie M Dodd1,2, Jennie Louise3,4, Andrea R Deussen5
1Department of Obstetrics and Gynaecology, The Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia. jodie.dodd@adelaide.edu.au.
BMC medicine
|May 15, 2024
概括
孕产妇的体重指数 (BMI) 影响怀孕的结果,但孕期体重增加 (GWG) 不介于这种影响. 过度的GWG与不良结果无关,挑战目前的管理实践.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 公共卫生 营养 公共卫生 营养
背景情况:
- 管理超重/肥胖妇女妊娠期体重增加 (GWG) 的指导方针是基于BMI,GWG和不良妊娠结果之间的假定因果关系.
- 这项研究调查了母亲怀孕前的体重指数 (BMI),GWG和怀孕结果之间的关系.
研究的目的:
- 评估母亲的BMI,GWG和不良妊娠结果之间的假设因果关系.
- 为了确定母体BMI对怀孕结果的影响是否通过GWG进行调解.
主要方法:
- 来自国际怀孕体重管理 (i-WIP) 合作的20项随机试验 (4370名对照参与者) 的个人参与者数据 (IPD) 分析.
- 使用通用线性模型和基于回归的调解分析来评估母亲的BMI,GWG (连续和"过度") 和怀孕结果 (出生体重,剖腹产) 之间的关系.
主要成果:
- 随着母亲的BMI增加,平均GWG线性下降,但"过度"GWG的风险在BMI类别值时增加.
- 增加母亲的BMI与所有评估的怀孕结果的风险增加有关.
- 没有证据表明,母亲的BMI对妊娠结果的影响是由GWG调解的.
结论:
- 母亲的BMI和GWG之间存在关系,以及母亲的BMI和不良妊娠结果之间存在关系.
- 孕产妇BMI对怀孕结果的影响不是通过GWG调解的.
- 这些发现挑战了积极管理GWG的做法,并表明"过度"的GWG与不良结果没有因果关系.
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