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Abstract：
This study was performed to investigate whether the Japanese guidelines for gestational weight gain (GWG) can be used to determine the risks of multiple pregnancy outcomes and estimate optimal GWG in 101,336 women with singleton pregnancies in 2013. Multivariable logistic regression analyses indicated that the risks associated with low birth weight, small for gestational age, and preterm birth increased significantly with weight gain below the Japanese guidelines, and the risks of macrosomia and large for gestational age increased with weight gain above the guidelines regardless of Asian-specific pre-pregnancy body mass index (BMI). The GWG cutoff points estimated from the adjusted area under the receiver operating characteristics curve >0.6 corresponded to 10-13.8 kg in underweight women with pre-pregnancy BMI < 18.5 kg/m2; 10-13.7 kg in normal weight women with pre-pregnancy BMI 18.5-22.9 kg/m2; 8.5-11.4 kg in overweight women with pre-pregnancy BMI 23-24.9 kg/m2, 5-13.3 kg in obese women with pre-pregnancy BMI 25-29.9 kg/m2; and 4.7 kg in obese women with pre-pregnancy BMI ≥ 30 kg/m2. The optimal GWG ranges proposed by the present study are slightly higher than those recommended by the current Japanese guidelines.
摘要：
进行这项研究是为了调查日本的妊娠期体重增加指南（GWG）是否可用于确定多胎妊娠结局的风险，并估计2013年101,336名单胎妊娠妇女的最佳GWG。多变量logistic回归分析表明，与低出生体重相关的风险，小于胎龄，早产随着体重增加而显著增加，低于日本指南，无论亚洲特定的孕前体重指数（BMI）如何，巨大儿和胎龄大的风险都会随着体重的增加而高于指南。根据受试者工作特征曲线下的调整面积>0.6估算的GWG截止点对应于孕前BMI<18.5kg/m2的体重不足妇女的10-13.8kg；正常体重妇女的10-13.7kg孕前BMI18.5-22.9kg/m2；超重妇女的孕前BMI23-24.9kg/m2，肥胖妇女的8.5-11.4kg；肥胖妇女的孕前BMI≥30kg/m2。本研究提出的最佳GWG范围略高于当前日本指南建议的范围。
