학술논문
Associations of Gestational Weight Gain with Preterm Birth among Underweight and Normal Weight Women.
Document Type
Article
Author
Source
Subject
*ANALYSIS of variance
*BIRTH certificates
*CHI-squared test
*CONFIDENCE intervals
*GESTATIONAL diabetes
*ETHNIC groups
*GESTATIONAL age
*HEALTH maintenance organizations
*HYPERTENSION in pregnancy
*PREMATURE infants
*INTEGRATED health care delivery
*LONGITUDINAL method
*MATERNAL age
*MEDICAID
*EVALUATION of medical care
*NOSOLOGY
*FIRST trimester of pregnancy
*SECOND trimester of pregnancy
*PREGNANT women
*PRENATAL care
*SELF-evaluation
*STATISTICS
*WEIGHT gain
*LOGISTIC regression analysis
*EDUCATIONAL attainment
*BODY mass index
*INTER-observer reliability
*RETROSPECTIVE studies
*PARITY (Obstetrics)
*DATA analysis software
*DESCRIPTIVE statistics
*ODDS ratio
*PREGNANCY
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Language
ISSN
1092-7875
Abstract
Studies report increased risk of preterm birth (PTB) among underweight and normal weight women with low gestational weight gain (GWG). However, most studies examined GWG over gestational periods that differ by term and preterm which may have biased associations because GWG rate changes over the course of pregnancy. Furthermore, few studies have specifically examined the amount and pattern of GWG early in pregnancy as a predictor of PTB. Within one integrated health care delivery system, we examined 12,526 singleton pregnancies between 2000 and 2008 among women with a body mass index <25 kg/m, who began prenatal care in the first trimester and delivered a live-birth >28 weeks gestation. Using self-reported pregravid weight and serial measured antenatal weights, we estimated GWG and the area under the GWG curve (AUC; an index of pattern of GWG) during the first and second trimesters of pregnancy (≤28 weeks). Using logistic regression adjusted for covariates, we examined associations between each GWG measure, categorized into quartiles, and PTB (<37 weeks gestation). We additionally examined associations according to the reason for PTB by developing a novel algorithm using diagnoses and procedure codes. Low GWG in the first and second trimesters was not associated with PTB [aOR 1.11, (95 % CI 0.90, 1.38) with GWG <8.2 kg by 28 weeks compared to pregnancies with GWG >12.9]. Similarly, pattern of GWG was not associated with PTB. Our findings do not support an association between GWG in the first and second trimester and PTB among underweight and normal weight women. [ABSTRACT FROM AUTHOR]