PDF(Pubmed)
Abstract：
The inherent correlation between the total amount of weight gained in pregnancy and the duration of pregnancy creates major methodological challenges in the study of pregnancy weight gain. In this issue (Am J Epidemiol. 2022;191(10):1687-1699), Richards et al. examine the extent to which different measures of pregnancy weight gain (including covariate adjustment for gestational age and standardizing weight gain for gestational duration using a pregnancy weight gain chart) are able to disentangle the effects of low weight gain on perinatal health from the role of younger gestational age at delivery for 3 outcomes: small-for-gestational-age birth, cesarean delivery, and low birth weight. While methodological research to understand how to best disentangle the effects of gestational weight gain from pregnancy duration is valuable, we argue that the practical utility of this type of research would be increased by aligning the specific research questions more closely with health outcomes on which evidence is most needed-those not considered in current weight gain guidelines due to lack of high-quality evidence (such as pre-eclampsia and stillbirth). Further, evaluations of weight gain charts should separate out the potential for bias introduced by the use of a normative chart per se from the use of a chart unsuitable for the study population.
摘要：
妊娠体重增加的总量与妊娠持续时间之间的内在相关性在妊娠体重增加的研究中产生了重大的方法学挑战。在本期(AmJEpidemium。2023年；XXX(XX)：XXXX-XXXX)，理查兹等人。检查不同的孕期体重增加措施(包括孕龄的协变量调整和使用孕期体重增加图标准化孕期体重增加)在多大程度上能够将低体重增加对围产期健康的影响与分娩时年轻孕龄的作用分开,剖宫产,低出生体重。虽然了解如何最好地从妊娠持续时间中解开妊娠体重增加的影响的方法学研究是有价值的，我们认为,通过将具体的研究问题与最需要证据的健康结局更紧密地结合起来,这类研究的实际效用将会增加,因为缺乏高质量的证据(如先兆子痫和死产),这些问题在目前的体重增加指南中没有被考虑.Further,对体重增加图表的评估应将使用规范图表本身带来的偏见与使用不适合研究人群的图表分开。
