Abstract：
BACKGROUND: Excess gestational weight gain (GWG) has adverse short- and long-term effects on the health of mothers and infants. In 2009, the US Institute of Medicine revised its guidelines for GWG and reduced the recommended GWG for women who are obese. There is limited evidence on whether these revised guidelines affected GWG and downstream maternal and infant outcomes.
METHODS: We used data from the 2004-2019 waves of the Pregnancy Risk Assessment Monitoring System, a serial cross-sectional national dataset including over 20 states. We conducted a quasi-experimental difference-in-differences analysis to assess pre/post changes in maternal and infant outcomes among women who were obese, while \"differencing out\" the pre/post changes among a control group of women who were overweight. Maternal outcomes included GWG and gestational diabetes; infant outcomes included preterm birth (PTB), low birthweight (LBW), and very low birthweight (VLBW). Analysis began in March 2021.
RESULTS: There was no association between the revised guidelines and GWG or gestational diabetes. The revised guidelines were associated with reduced PTB (- 1.19% points, 95%CI: - 1.86, - 0.52), LBW (- 1.38% points 95%CI: - 2.07, - 0.70), and VLBW (- 1.30% points, 95%CI: - 1.68, - 0.92). Results were robust to several sensitivity analyses.
CONCLUSIONS: The revised 2009 GWG guidelines were not associated with changes in GWG or gestational diabetes but were associated with improvements in infant birth outcomes. These findings will help inform further programs and policies aimed at improving maternal and infant health by addressing weight gain in pregnancy.
METHODS: We used data from the 2004-2019 waves of the Pregnancy Risk Assessment Monitoring System, a serial cross-sectional national dataset including over 20 states. We conducted a quasi-experimental difference-in-differences analysis to assess pre/post changes in maternal and infant outcomes among women who were obese, while \"differencing out\" the pre/post changes among a control group of women who were overweight. Maternal outcomes included GWG and gestational diabetes; infant outcomes included preterm birth (PTB), low birthweight (LBW), and very low birthweight (VLBW). Analysis began in March 2021.
RESULTS: There was no association between the revised guidelines and GWG or gestational diabetes. The revised guidelines were associated with reduced PTB (- 1.19% points, 95%CI: - 1.86, - 0.52), LBW (- 1.38% points 95%CI: - 2.07, - 0.70), and VLBW (- 1.30% points, 95%CI: - 1.68, - 0.92). Results were robust to several sensitivity analyses.
CONCLUSIONS: The revised 2009 GWG guidelines were not associated with changes in GWG or gestational diabetes but were associated with improvements in infant birth outcomes. These findings will help inform further programs and policies aimed at improving maternal and infant health by addressing weight gain in pregnancy.
摘要：
背景：妊娠期体重增加过多（GWG）会对母亲和婴儿的健康产生短期和长期不利影响。2009年，美国医学研究所修订了GWG指南，并减少了对肥胖女性的推荐GWG。关于这些修订的指南是否影响GWG和下游母婴结局的证据有限。
方法：我们使用了2004-2019年怀孕风险评估监测系统波的数据，包括20多个州的连续横截面国家数据集。我们进行了准实验性差异分析，以评估肥胖女性的母婴结局的前/后变化，而“区分”超重女性对照组的前/后变化。孕产妇结局包括GWG和妊娠期糖尿病；婴儿结局包括早产（PTB），低出生体重（LBW），和非常低的出生体重（VLBW）。分析于2021年3月开始。
结果：修订后的指南与GWG或妊娠期糖尿病没有关联。修订后的指南与降低PTB相关(-1.19%，95CI：-1.86，-0.52），LBW（-1.38%点95CI：-2.07，-0.70），和VLBW(-1.30%点，95CI：-1.68，-0.92）。结果对一些敏感性分析是稳健的。
结论：2009年修订的GWG指南与GWG或妊娠糖尿病的变化无关，但与婴儿出生结局的改善有关。这些发现将有助于为旨在通过解决怀孕体重增加来改善母婴健康的进一步计划和政策提供信息。
方法：我们使用了2004-2019年怀孕风险评估监测系统波的数据，
结果：修订后的指南与GWG或妊娠期糖尿病没有关联。
结论：2009年修订的GWG指南与GWG或妊娠糖尿病的变化无关，但与婴儿出生结局的改善有关。
