妊娠期体重增加过高,再加上育龄妇女肥胖率稳步上升,代表了一个巨大的产科问题,由于肥胖和妊娠期高体重增加与胎儿生长增强有关,低生命参数,和增加剖宫产率。这项基于医疗记录的研究调查了过低和过高的妊娠期体重增加之间的关联模式,根据2009年医学研究所(IOM)的指导方针,和胎儿的生长,以及分娩方式和妊娠结局。2010年至2020年在维也纳的Donaustadt公共诊所发生的11,755例单胎出生的数据,奥地利,进行了分析。出生体重,出生长度,头围,APGAR分数,和动脉脐带血的pH值描述了胎儿的生长以及出生后的重要参数。妊娠体重增加被归类为过低,推荐,或根据IOM指南的不同体重状态类别过高。出生体重,出生长度,体重过轻的新生儿头围明显增加(p<0.001),正常体重,和超重的女性体重增加超过建议。在肥胖女性中,在体重增加的女性中,仅出生体重显著高于推荐的(p<0.001).此外,孕期体重增加过高与体重不足的巨大儿和紧急剖宫产的风险增加显著相关,正常体重,超重的女性,但不是肥胖的。肥胖和病态肥胖的妇女经历妊娠期体重过度增加,显示巨大儿或紧急剖宫产的风险没有显着增加。然而,在肥胖的母亲中,孕期体重增加过低,可显著降低紧急剖宫产的风险(p=0.010).因此,IOM关于妊娠期体重增加的建议仅部分适用于奥地利的孕妇.对于肥胖和病态肥胖的女性,应考虑最佳孕期增重的新指南.
A too-high gestational weight gain, in combination with steadily increasing obesity rates among women of reproductive age, represents an enormous obstetrical problem, as obesity and high gestational weight gain are associated with enhanced fetal growth, low vital parameters, and increased cesarean section rates. This medical record-based study investigates the association patterns between too-low as well as too-high gestational weight gain, according to the 2009 Institute of Medicine (IOM) guidelines, and fetal growth, as well as birth mode and pregnancy outcome. The data of 11,755 singleton births that had taken place between 2010 and 2020 at the Public Clinic Donaustadt in Vienna, Austria, were analyzed. Birth weight, birth length, head circumference, APGAR scores, and pH values of the arterial umbilical cord blood described fetal growth as well as the vital parameters after birth. Gestational weight gain was classified as too low, recommended, or too high according to the different weight status categories of the IOM guidelines. Birth weight, birth length, and head circumference of the newborn were significantly increased (p < 0.001) among underweight, normal-weight, and overweight women who gained more weight than recommended. Among obese women, only birthweight was significantly (p < 0.001) higher among women who gained more weight than recommended. Furthermore, a too-high gestational weight gain was significantly associated with an increased risk of macrosomia and emergency cesarean sections among underweight, normal-weight, and overweight women, but not among obese ones. Obese and morbidly obese women experiencing excessive gestational weight gain showed no significantly increased risk of macrosomia or emergency cesarean section. However, among obese mothers, a too-low gestational weight gain reduced the risk of emergency cesarean sections significantly (p = 0.010). Consequently, the IOM recommendations for gestational weight gain fit only partly for pregnant women in Austria. In the case of obese and morbidly obese women, new guidelines for optimal pregnancy weight gain should be considered.