Trajectory Patterns of Gestational Weight Gain.

IF 6.8 4区 医学 Q1 NUTRITION & DIETETICS Journal of the American Nutrition Association Pub Date : 2023-09-01 DOI:10.1080/27697061.2022.2125099
Fernanda Manera, Renata Cordeiro Fernandes, Doroteia Aparecida Höfelmann
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Abstract

Objective: To identify gestational weight gain trajectories and their association with demographic, obstetric, and anthropometric characteristics.

Method: Information of 599 pregnant women undergoing prenatal care in public health units was collected through questionnaires and medical records, resulting in 4,272 measures of body weight. Group-based trajectory models were applied to identify patterns of gestational weight gain.

Results: The average gestational weight gain at 40 weeks was 14.1 kg (95%CI: 13.2, 15.0). Three different trajectory groups were identified: low (9.9%), intermediate (66.4%), and high (23.7%). Pregnant women who smoked and those classified above IOM's weight gain recommendations were more likely to be classified in the group with a high weight gain trajectory; while those with pre-pregnancy overweight or obesity, and with greater parity were more likely to be categorized in the low weight gain trajectory. After adjusting for other variables in the model, parity remained significantly associated with gestational weight gain (β: 0.88; 95%CI: 0.27, 0.73). In the multilevel model, weight gain remained different among the categories of group-based trajectory, even after adjustment for other investigated variables for intermediate (β: 2.94; 95%CI: 2.32, 3.58) and high (β: 5.88; 95%CI: 5.09, 6.66) gestational weight gain trajectory groups.

Conclusions: Behavioral, obstetric, and anthropometric characteristics determined the belonging to groups with a high or low trajectory of gestational weight gain. The findings contribute to a better understanding of patterns of gestational weight gain in middle-income women groups.

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妊娠期体重增加的轨迹模式
目的:确定妊娠期体重增加轨迹及其与人口统计学、产科和人体测量学特征的关系。方法:对599名在公共卫生机构接受产前护理的孕妇进行问卷调查和病历记录,测量体重4272次。采用基于群体的轨迹模型来确定妊娠期体重增加的模式。结果:40周时平均妊娠体重增加14.1 kg (95%CI: 13.2, 15.0)。确定了三个不同的轨迹组:低(9.9%)、中(66.4%)和高(23.7%)。吸烟的孕妇和那些超过IOM体重增加建议的孕妇更有可能被归为高体重增加轨迹组;而那些怀孕前超重或肥胖的人,以及胎次较大的人更有可能被归类为体重增加较少的人。在调整模型中的其他变量后,胎次仍与妊娠体重增加显著相关(β: 0.88;95%ci: 0.27, 0.73)。在多水平模型中,体重增加在群体轨迹的类别之间仍然存在差异,即使在调整了其他被调查变量的中间值(β: 2.94;95%CI: 2.32, 3.58)和高(β: 5.88;95%CI: 5.09, 6.66)妊娠体重增加轨迹组。结论:行为、产科和人体测量学特征决定了属于妊娠体重增加高或低轨迹组。这些发现有助于更好地理解中等收入妇女群体妊娠期体重增加的模式。
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