■2009年医学研究所(IOM)妊娠期体重增加(GWG)指南最初是在美国为孕妇制定的。
■本研究旨在调查IOM指南是否适合中国孕妇。
在北京妇产医院(2018年1月1日至2019年12月31日)进行了一项包括20,593名单胎孕妇的回顾性队列研究。通过将预测的复合风险曲线的最低点对应的GWG与2009年IOMGWG指南进行比较来评估适用性。国际移民组织指南是GWG类别和孕前体重指数的标准。采用指数函数模型对孕期体重增加和剖宫产概率进行拟合,早产,小于胎龄,和大的胎龄。采用二次函数模型拟合上述不良妊娠结局的综合概率。通过将最低预测概率对应的权重与IOM指南建议的GWG范围进行比较,评估了IOM指南的适用性。
■根据2009年IOMGWG指南,43%的女性达到了足够的体重,近32%的人体重增加过多,25%的人体重不足。IOM提出的GWG范围包括体重不足女性的最低预测概率值,超过了正常体重的最低预测概率值,超重,肥胖的女人.
■2009年IOM指南适用于孕前体重指数被归类为体重不足的中国女性。指南不适用于正常人,超重,或肥胖的孕前体重指数分类。因此,根据上述证据,2009年国际移民组织指南并不适合所有中国女性。
The 2009 Institute of Medicine (IOM) gestational weight gain (GWG)
guidelines were initially developed for pregnant women in the United States.
This study aimed to investigate whether the IOM
guidelines were suitable for pregnant Chinese women.
A retrospective cohort study comprising 20,593 singleton pregnant women was conducted at the Beijing Obstetrics and Gynaecology Hospital (1 January 2018 to 31 December 2019). Applicability was evaluated by comparing the GWG corresponding to the lowest point of the predicted composite risk curve with the 2009 IOM GWG Guidelines. The IOM
Guidelines serve as the standard for the GWG categories and the pre-pregnancy body mass index. An exponential function model was used to fit the weight gain during pregnancy and the probability of caesarean section, preterm birth, small for gestational age, and large for gestational age. A quadratic function model was used to fit the combined probability of the above-mentioned adverse pregnancy outcomes. The applicability of the IOM guidelines was evaluated by comparing the weights corresponding to the lowest predicted probability with the GWG range recommended by the IOM
guidelines.
According to the 2009 IOM GWG Guidelines, 43% of the women achieved adequate weight, almost 32% gained excessive weight, and 25% gained inadequate weight. The GWG range proposed by the IOM included the lowest predicted probability value for underweight women and exceeded the lowest predicted probability for normal weight, overweight, and obese women.
The 2009 IOM guidelines were suitable for Chinese women whose pre-pregnancy body mass index was classified as underweight. The guidelines were not suitable for normal, overweight, or obese pre-pregnancy body mass index classifications. Therefore, based on the above evidence, the 2009 IOM
guidelines are not suitable for all Chinese women.