期刊
ANNALS OF EPIDEMIOLOGY
卷 21, 期 2, 页码 78-85出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.annepidem.2010.06.009
关键词
Birth Weight; Cesarean Delivery; Fetal Growth Retardation; Fetal Macrosomia; Infant; Small-for-Gestational Age; Premature Birth; Weight Gain
资金
- Institute of Medicine (IOM)
- National Institute of Child Health and Human Development [R21 HD050739]
PURPOSE: The obesity epidemic raises concerns about the impact of excessive and insufficient weight gain during pregnancy. METHODS: We examined the association between gestational weight gain (GWG) and preterm birth, term small- and large-for-gestational-age (SGA and LGA), term birthweight, and term primary Cesarean delivery, considering prepregnancy body mass index (BMI) and ethnicity in a cohort of 33,872 New York City residents who gave birth between 1995 and 2003 and delivered in hospitals elsewhere in New York State. RESULTS: Preterm birth (<37 weeks' gestation) showed a modest U-shaped relationship, with projected GWG of <10 kg and 20+ kg associated with odds ratios of 1.4 and 1.3, respectively, relative to 10 to 14 kg. The pattern was stronger for preterm birth <32 weeks' and for underweight women with low GWG and overweight/obese women with high GWG. Term SGA decreased and term LGA and birthweight increased monotonically with increasing GWG. Primary Cesarean delivery followed the same pattern as LGA, but less strongly. CONCLUSIONS: Although the study is limited by potential selection bias and measurement error, our findings support the contention that GWG may be a modifiable predictor of pregnancy outcome that warrants further investigation, particularly randomized trials, to assess whether the relation is causal. Ann Epidemiol 2011;21:78-85. (C) 2011 Elsevier Inc. All rights reserved.
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