PDF(Pubmed)
Abstract：
Pregnancy is an excellent opportunity to provide medical interventions to women. It is also a stress test used to predict health. Numerous studies have demonstrated that the pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are critical factors for pregnancy complications such as hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), large or small gestational age infants, and spontaneous preterm birth (sPTB). These complications are associated with an increased risk of cardiovascular disease (CVD), which is a leading cause of mortality in women. In addition, complications adversely affect the short- and long-term prognoses of children. Optimal GWG to reduce complications is recommended based on pre-pregnancy BMI; however, racial differences should also be noted. The values in the Japanese guidelines are lower than those in the American Institute of Medicine guidelines. The Asian BMI thresholds for CVD risk are also lower than those in Europe. Therefore, weight management should be based on racial/genetic background. Interpregnancy weight gain or loss has also been reported to be associated with the risk of pregnancy complications; however, few studies have been conducted in Asian populations. Our previous reports suggested that avoiding an excess of 0.6 kg/m2/year of annual BMI gain may reduce the risk of HDP or GDM, and insufficient gain of < 0.25 kg/m2/year may increase sPTB recurrence. Annual BMI is useful for practical weight control during interpregnancy. Based on these findings, effective approaches should be established to improve the health of women and their offspring.
摘要：
怀孕是为妇女提供医疗干预的绝佳机会。这也是用于预测健康的压力测试。大量研究表明，孕前体重指数（BMI）和妊娠体重增加（GWG）是妊娠并发症的关键因素，例如妊娠高血压疾病（HDP）。妊娠期糖尿病(GDM),大或小胎龄婴儿，和自发性早产（sPTB）。这些并发症与心血管疾病（CVD）的风险增加有关。这是女性死亡的主要原因。此外,并发症会对儿童的短期和长期预后产生不利影响。根据孕前BMI，建议使用最佳GWG来减少并发症；但是，还应该注意种族差异。日本指南中的值低于美国医学研究所指南中的值。亚洲心血管疾病风险的BMI阈值也低于欧洲。因此,体重管理应基于种族/遗传背景。据报道，孕期体重增加或减少与妊娠并发症的风险有关；然而，在亚洲人群中进行的研究很少。我们以前的报告表明，避免每年BMI增加超过0.6kg/m2/年可能会降低HDP或GDM的风险，和<0.25kg/m2/年的不足增重可能会增加sPTB复发。每年的BMI对于怀孕期间的实际体重控制是有用的。基于这些发现,应建立有效的方法来改善妇女及其后代的健康。
