医学
体重增加
怀孕
优势比
产科
置信区间
肥胖
体质指数
妊娠期
内科学
体重
遗传学
生物
作者
Wei Song,Zhi Zhang,Wei Zheng,Lei Gao,Shengnan Liang,Dongmei Cheng,Xiaoxin Wang,Cuimei Guo,Guanghui Li
摘要
Gestational weight management in obese women is critical in clinical work. Adverse pregnancy outcomes are associated with improper gestational weight gain (GWG). However, the pattern of GWG (PGWG) and its correlation with hypertensive disorders of pregnancy (HDP) in obesity are still unclear in China. This retrospective cohort study evaluates clinical data from 799 women through multivariate analyses and trajectory analyses. All the participants are stratified per first trimester weight gain category into three groups (Inadequate-1st, <0.5 kg; Adequate-1st, 0.5–2.0 kg; Excessive-1st, >2.0 kg) and PGWG refers to the weekly weight gain during each gestational period. GWG is positively associated with first trimester weight gain. 78.4% of the Excessive-1st participants have excessive total GWG, in contrast to Inadequate-1st (32.7%) and Adequate-1st (48.2%). After 20 weeks, the weekly weight gain rapidly accelerates, and 77.3% have a weekly weight gain exceeding the Institute of Medicine recommendations. Trajectory analysis of weekly weight gain based on HDP shows two separate weight gain curves after 20 weeks in women with and without a high risk of HDP. Especially in Excessive-1st participants, weekly weight gain after 20 weeks over 0.32 kg/w is positively related to the risk of HDP (<0.32 kg/w vs. 0.32–0.61 kg/w, adjusted odds ratios [aOR]: 2.999, 95% confidence interval [CI]: 1.054–8.537; <0.32 kg/w vs. >0.61 kg/w, aOR: 5.362, 95% CI: 1.719–16.729). In summary, the first trimester is critical for gestational weight management in obesity. Excessive weight gain during the first trimester and after 20 weeks predicts a high risk of HDP, which should be noted in clinical practice.
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