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首页> 外文期刊>Journal of women’s health >Impact of updated institute of medicine guidelines on prepregnancy body mass index categorization, gestational weight gain recommendations, and needed counseling.
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Impact of updated institute of medicine guidelines on prepregnancy body mass index categorization, gestational weight gain recommendations, and needed counseling.

机译：最新医学研究所指南对孕前体重指数分类，妊娠体重增加建议和需要咨询的影响。

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Abstract Background: Our objective was to quantify how the 2009 revisions of the 1990 Institute of Medicine (IOM) gestational weight gain (GWG) guidelines change women's body mass index (BMI) categorization and BMI-specific GWG adherence categories. The goal was to identify how provider counseling practices need to change on a population level. Methods: A retrospective review of automated labor and delivery records from a tertiary care hospital in Central Massachusetts was performed. The study cohort included women who delivered singleton, live birth gestations from from April 1, 2006, to September 30, 2009. Records missing weight, height, GWG, gestational age (GA), and/or GA <22 or >43 weeks were excluded. BMI groups and GWG adherence were categorized according to IOM 1990 and 2009 recommendations. Adherence analyses included full-term gestations only. Results: The cohort consisted of 11,688 women, mean age 28.9 (+/-6.1) years and mean parity 1.0 (+/-1.1). By 1990 recommendations, 10.1%, 52.5%, 14.1%, and 23.3% gravidas were low weight, normal weight, high weight, and obese; and 19.8%, 33.3%, and 46.9% were undergainers, appropriate gainers, and overgainers, respectively. By 2009 recommendations, 3.9%, 51.3%, 24.5%, and 20.3% gravidas were underweight, normal weight, overweight, and obese, and 16.7%, 30.8%, and 52.6% were undergainers, appropriate gainers, and overgainers, respectively. Differences in categorization by guideline year was significant for BMI category (p<0.0001) and GWG adherence (p<0.0001). Compared to 1990 guidelines, 16.7% of women were classified differently using 2009 guidelines, with fewer classified as underweight, normal weight, or obese and more as overweight; 17.1% of 1990 appropriate gainers would be classified as overgainers, given new guidelines. Conclusions: Changes in IOM GWG recommendations alter gravidas' BMI categories and, thus, the recommended GWG. As the amount advised is associated with actual gain, accuracy is paramount. GWG is a modifiable parameter associated with immediate and long-term maternaleonatal health outcomes, and counseling can have a significant public health impact and should involve BMI determination, followed by BMI-specific GWG recommendations in accordance with current guidelines.
机译：摘要背景：我们的目标是量化1990年医学研究所（IOM）妊娠体重增加（GWG）指南的2009年修订版如何改变女性体重指数（BMI）类别和特定于BMI的GWG依从性类别。目的是确定提供者咨询实践需要如何在人群水平上进行改变。方法：回顾性审查马萨诸塞州中部一家三级医院的自动分娩和分娩记录。该研究队列包括从2006年4月1日至2009年9月30日分娩单胎活产的妇女。记录的体重，身高，GWG，胎龄（GA）和/或GA <22或> 43周排除在外。 BMI组和GWG依从性根据IOM 1990和2009建议进行分类。依从性分析仅包括足月妊娠。结果：该队列包括11,688名女性，平均年龄28.9（+/- 6.1）岁，平均胎次1.0（+/- 1.1）。根据1990年的建议，低体重，正常体重，高体重和肥胖的孕妇分别有10.1％，52.5％，14.1％和23.3％的体重。分别有19.8％，33.3％和46.9％的收益不足者，适当收益者和过度收益者。根据2009年的建议，体重不足，正常体重，超重和肥胖的孕妇分别为3.9％，51.3％，24.5％和20.3％，体重不足，适当增加和过度的孕妇分别为16.7％，30.8％和52.6％。对于BMI类别（p <0.0001）和GWG依从性（p <0.0001），按指南年划分的分类差异显着。与1990年的指南相比，根据2009年的指南，对16.7％的妇女进行了不同的分类，体重过轻，正常体重或肥胖的妇女较少，而超重的妇女则更多。根据新的指导原则，将1990年适当获利者的17.1％归类为获利者。结论：IOM GWG建议的更改改变了孕妇的BMI类别，从而改变了建议的GWG。由于建议的数量与实际增益相关，因此精度至关重要。 GWG是与立即和长期孕产妇/新生儿健康结果相关的可修改参数，咨询可能会对公众健康产生重大影响，并且应涉及BMI的确定，然后根据当前指南，针对BMI制定GWG建议。

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