Abstract：
OBJECTIVE: To analyze the associations between gestational weight gain (GWG) and perinatal outcomes based on the GWG guidelines of the Chinese Nutrition Society (CNS) and the Institute of Medicine (IOM).
METHODS: This was a retrospective study with 9075 low-risk singleton pregnant women. Logistic regression model was used to analyze associations between GWG categories and perinatal outcomes. Sensitivity analyses were performed based on pre-pregnancy body mass index (calculated as weight in kilograms divided by the square of height in meters).
RESULTS: Excessive GWG as defined by the two guidelines was associated with a higher risk of adverse perinatal outcomes. Inadequate GWG was associated with higher risks of small for gestational age (adjusted odds ratio [aOR] 1.34, 95% confidence interval [CI] 1.10-1.64) and preterm birth (aOR 1.70, 95% CI 1.22-2.36), but a lower risk of large for gestational age (LGA) (aOR 0.77, 95% CI 0.63-0.95) according to the IOM guidelines. When using the CNS guidelines, inadequate GWG was associated with only a lower risk of preterm birth (aOR 1.80, 95% CI 1.19-2.70). Sensitivity analyses suggested that excessive GWG was associated with a higher risk of LGA in underweight women.
CONCLUSIONS: Both guidelines could demonstrate the relationship between GWG and adverse perinatal outcomes. The CNS guidelines were more suitable for the Chinese population with underweight or normal weight before pregnancy, whereas IOM was more suitable for pregnant women with inadequate GWG.
METHODS: This was a retrospective study with 9075 low-risk singleton pregnant women. Logistic regression model was used to analyze associations between GWG categories and perinatal outcomes. Sensitivity analyses were performed based on pre-pregnancy body mass index (calculated as weight in kilograms divided by the square of height in meters).
RESULTS: Excessive GWG as defined by the two guidelines was associated with a higher risk of adverse perinatal outcomes. Inadequate GWG was associated with higher risks of small for gestational age (adjusted odds ratio [aOR] 1.34, 95% confidence interval [CI] 1.10-1.64) and preterm birth (aOR 1.70, 95% CI 1.22-2.36), but a lower risk of large for gestational age (LGA) (aOR 0.77, 95% CI 0.63-0.95) according to the IOM guidelines. When using the CNS guidelines, inadequate GWG was associated with only a lower risk of preterm birth (aOR 1.80, 95% CI 1.19-2.70). Sensitivity analyses suggested that excessive GWG was associated with a higher risk of LGA in underweight women.
CONCLUSIONS: Both guidelines could demonstrate the relationship between GWG and adverse perinatal outcomes. The CNS guidelines were more suitable for the Chinese population with underweight or normal weight before pregnancy, whereas IOM was more suitable for pregnant women with inadequate GWG.
摘要：
目的：根据中国营养学会（CNS）和医学研究所（IOM）的GWG指南，分析妊娠期体重增加（GWG）与围产期结局之间的关系。
方法：这是一项对9075名低风险单胎孕妇的回顾性研究。使用Logistic回归模型分析GWG类别与围产期结局之间的关联。敏感性分析是根据孕前体重指数（以千克为单位的体重除以米为单位的身高平方计算）进行的。
结果：两个指南定义的过高GWG与不良围产期结局的风险相关。GWG不足与更高的小于胎龄的风险（调整后的比值比[aOR]1.34，95％置信区间[CI]1.10-1.64）和早产（aOR1.70，95％CI1.22-2.36）相关，但根据IOM指南，孕龄较大（LGA）的风险较低（aOR0.77，95％CI0.63-0.95）。使用CNS指南时，GWG不足仅与较低的早产风险相关(aOR1.80,95%CI1.19-2.70).敏感性分析表明，在体重不足的女性中，过度GWG与LGA的高风险相关。
结论：这两个指南都可以证明GWG与不良围产期结局之间的关系。CNS指南更适合孕前体重不足或体重正常的中国人群,而IOM更适合GWG不足的孕妇。
方法：这是一项对9075名低风险单胎孕妇的回顾性研究。使用Logistic回归模型分析GWG类别与围产期结局之间的关联。敏感性分析是根据孕前体重指数（以千克为单位的体重除以米为单位的身高平方计算）进行的。
结果：两个指南定义的过高GWG与不良围产期结局的风险相关。GWG不足与更高的小于胎龄的风险（调整后的比值比[aOR]1.34，95％置信区间[CI]1.10-1.64）和早产（aOR1.70，95％CI1.22-2.36）相关，但根据IOM指南，孕龄较大（LGA）的风险较低（aOR0.77，95％CI0.63-0.95）。使用CNS指南时，GWG不足仅与较低的早产风险相关(aOR1.80,95%CI1.19-2.70).敏感性分析表明，在体重不足的女性中，过度GWG与LGA的高风险相关。
结论：这两个指南都可以证明GWG与不良围产期结局之间的关系。CNS指南更适合孕前体重不足或体重正常的中国人群,而IOM更适合GWG不足的孕妇。
