重新评估妊娠各个阶段的最佳体重变化
Diana Aboukhater1, Misa Hayasaka1, Juliana Martins1
1Department of Obstetrics and Gynecology, Macon and Joan Brock Virginia Health Sciences Eastern Virginia Medical School at ODU, Norfolk, VA.
American journal of obstetrics and gynecology
|March 29, 2025
概括
最佳的每周妊娠体重增加因孕期和妊娠前的BMI而异,目前的指导方针可能过于限制. 在大多数BMI类别中,较高的推体重增加率与较少的不良妊娠结果有关.
科学领域:
- 孕产妇与胎儿医学 孕产妇与胎儿医学
- 产科和妇科 产科和妇科
- 公共卫生 营养 公共卫生 营养
背景情况:
- 目前关于妊娠体重增加 (GWG) 的指导方针主要集中在总体重增加上,对每三个月每周增加的指导不那么具体.
- 美国国家医学院 (NAM) 提供了建议,但最佳的每周体重增加范围以怀孕前的体重指数 (BMI) 进行分层,仍未得到充分探索.
研究的目的:
- 为了确定与减少不良妊娠结果相关的最佳每周妊娠体重增加率.
- 将这些最佳率按每个孕期的妊娠前体重指数 (BMI) 类别分层.
主要方法:
- 预期无卵性妊娠结果研究的二次分析:监测即将成为母亲 (2010-2014) 队列.
- 计算的每周体重变化 (千克/周) 在早期,第二和第三个三个月.
- 使用具有受限制立方线的通用线性模型来评估每周体重变化与不良妊娠结果的复合 (高血压障碍,早产,怀孕年龄较小,死产) 之间的关联.
主要成果:
- 与最低不良风险相关的最佳每周体重增加率因BMI和季度而异:例如,对于正常/体重不足,每周0.7公斤 (1st),每周0.7公斤 (2nd),每周0.5公斤 (3rd);对于肥胖者,每周0.6公斤 (1st),每周0.5公斤 (2nd),每周0.4公斤 (3rd).
- 与最佳率相比,NAM对第二个三个月的指导方针与正常/体重不足和超重个体的不良结果和较小的妊娠年龄分娩风险增加有关.
- 对于第三个三个月的肥胖个体,NAM指南与最佳率相比,剖腹产风险降低有关.
结论:
- 在这项研究中发现的最佳每周妊娠体重增加率通常高于NAM建议.
- 这些发现表明,目前NAM关于妊娠期体重增加的指导方针可能过于限制,可能导致某些BMI群体的不良妊娠结果增加.
相关概念视频
Regression Toward the Mean
6.3K
Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when...
6.3K
Nursing Evaluation
4.1K
The evaluation stage signals the end of the nursing process. The nurse gathers evaluative data to assess whether or not the patient has attained the expected results. Whereas the nurse collects data in the nursing assessment to identify the patient's health concerns, the evaluation stage data determines if the indicated health issues are resolved. Evaluative data collection includes two sections: the data acquired to evaluate patient outcomes and the time criteria for data collection.
4.1K
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
627
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
627
Drug Dosing: Obese Patients
368
In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
368
Study Designs in Epidemiology
1.6K
Epidemiological study designs are fundamental tools for investigating the distribution, determinants, and control of health conditions in populations. They help researchers understand the relationships between exposures and outcomes, and they broadly fall into two categories: "observational" and "experimental" studies.
Observational studies are those where the researcher does not intervene but rather observes natural variations. They include cross-sectional, cohort, and...
Observational studies are those where the researcher does not intervene but rather observes natural variations. They include cross-sectional, cohort, and...
1.6K
Mitral Valve Prolapse III: Nursing Management
586
The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
586


