Gestational weight gain standards based on women enrolled in the Fetal Growth Longitudinal Study of the INTERGROWTH-21 st Project: a prospective longitudinal cohort study

作者：Leila Cheikh Ismail, Deborah C. Bishop, Ruyan Pang, Eric O. Ohuma, Gilberto Kac, Barbara Abrams, Kathleen M. Rasmussen, Fernando C. Barros, Jane E. Hirst, Ann Lambert, Aris T. Papageorghiou, William Stones, Yasmin A. Jaffer, Douglas G. Altman, J. Alison Noble, Maria Rosa Giolito, Michael G. Gravett, Manorama Purwar, Stephen Kennedy, Zulfiqar A Bhutta, José R. Villar · 发表于：BMJ · 年份：2016 · DOI：10.1136/bmj.i555 · 被引用次数：174 · 研究领域：Gestational Diabetes Research and Management、Pregnancy and preeclampsia studies、Cancer Risks and Factors

OBJECTIVE: To describe patterns in maternal gestational weight gain (GWG) in healthy pregnancies with good maternal and perinatal outcomes. DESIGN: Prospective longitudinal observational study. SETTING: Eight geographically diverse urban regions in Brazil, China, India, Italy, Kenya, Oman, United Kingdom, and United States, April 2009 to March 2014. PARTICIPANTS: Healthy, well nourished, and educated women enrolled in the Fetal Growth Longitudinal Study component of the INTERGROWTH-21(st) Project, who had a body mass index (BMI) of 18.50-24.99 in the first trimester of pregnancy. MAIN OUTCOME MEASURES: Maternal weight measured with standardised methods and identical equipment every five weeks (plus/minus one week) from the first antenatal visit (<14 weeks' gestation) to delivery. After confirmation that data from the study sites could be pooled, a multilevel, linear regression analysis accounting for repeated measures, adjusted for gestational age, was applied to produce the GWG values. RESULTS: 13,108 pregnant women at <14 weeks' gestation were screened, and 4607 met the eligibility criteria, provided consent, and were enrolled. The variance within sites (59.6%) was six times higher than the variance between sites (9.6%). The mean GWGs were 1.64 kg, 2.86 kg, 2.86 kg, 2.59 kg, and 2.56 kg for the gestational age windows 14-18(+6) weeks, 19-23(+6) weeks, 24-28(+6) weeks, 29-33(+6) weeks, and 34-40(+0) weeks, respectively. Total mean weight gain at 40 weeks' gestation was 13.7 ...