AIM:The aim of this study was to determine maternal and neonatal outcomes of less than recommended or excess gestational weight gain (GWG) based on the recommended Institute of Medicine (IOM) guidelines. MATERIAL AND METHODS:Using a cross-sectional study design, GWG was assessed for 1462 pregnant women presenting to a tertiary care perinatal institute in India. Body mass index at baseline, co-existing morbidities, fetal growth, details of delivery, and maternal and fetal outcomes were determined and documented. Appropriate GWG for each woman was determined based on the revised IOM guidelines. Outcome measures included the proportion of pregnant women compliant with IOM guidelines for GWG and associations of less than recommended or excess GWG with maternal and neonatal outcomes. RESULTS:A total of 547 (37.41%, 95% confidence interval [CI]: 34.96-39.92) pregnant women gained less than recommended and 313 (21.41%, 95%CI: 19.36-23.57) pregnant women gained more than the recommended weight. Preterm deliveries were associated with less than optimal weight gain (adjusted odds ratio 3.58, 95%CI: 1.75-7.32) after adjusting for gestational age at delivery. GWG was not associated with neonatal outcomes in this population. CONCLUSIONS:The lack of associations with perinatal outcomes indicates that the IOM guidelines may not be the appropriate standard for monitoring GWG in this population.

译文

目的:本研究的目的是根据推荐的医学研究所(IOM)指南确定孕产妇和新生儿的结局低于建议的或超过的妊娠体重增加(GWG)。
材料与方法:采用横断面研究设计,对印度的三级围产期研究所就诊的1462名孕妇进行了GWG评估。确定并记录基线时的体重指数,并存发病率,胎儿生长,分娩细节以及母婴结局。根据修订的IOM指南确定每位妇女的适当GWG。结果指标包括符合IOM GWG指导原则的孕妇比例,以及低于或超过GWG推荐值的孕妇和新生儿结局。
结果:共有547名(37.41%,95%置信区间[CI]:34.96-39.92)孕妇体重增加低于建议值,而313名(21.41%,95%CI:19.36-23.57)孕妇体重增加超过建议体重。调整分娩时的胎龄后,早产会导致体重增加不理想(调整后的比值比为3.58,95%CI:1.75-7.32)。 GWG与该人群的新生儿结局无关。
结论:缺乏与围产期结局的联系表明,IOM指南可能不是监测该人群GWG的合适标准。

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