BACKGROUND Women with obesity are at increased risk of excessive gestational weight gain. Women with a body mass index (BMI) of 40 kg/m2 or more are known to have different patterns of weight gain than women with lower levels of obesity. This study therefore aimed to determine the characteristics associated with gestational weight gain (GWG) among women with a BMI of 40 kg/m2 or more. METHODS Secondary analysis was undertaken on a retrospective cohort of women with a BMI of 40 kg/m2 or more, with a singleton pregnancy referred to an antenatal healthy lifestyle service between 2009 and 2015 (n = 735). GWG was calculated by subtracting weight at the first antenatal appointment from final recorded weight in pregnancy provided the final weight was recorded from at least 34 + 0 weeks gestation. Univariable and multiple linear regression analyses were employed to determine the association between GWG and different maternal and infant characteristics. RESULTS Average GWG among women with a BMI of 40 kg/m2 or more was 6.0 (±7.1)kg. Multiple regression showed GWG decreased with increasing BMI and increasing parity. Other socio-demographic factors were also significantly associated with GWG, with higher GWG seen among those with high levels of deprivation, where the highest household occupation was of a manual nature, in older women and women of non-White British ethnicity. CONCLUSION GWG in this cohort of women with a BMI of 40 kg/m2 or more was within Institute of Medicine recommendations. Using a systems approach to GWG management that incorporates biological, psychological and socio-ecological factors is important.

中文翻译：

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与病态肥胖女性妊娠期体重增加相关的因素。

背景技术肥胖女性妊娠期体重过度增加的风险增加。众所周知，体重指数 (BMI) 为 40 kg/m2 或以上的女性与肥胖程度较低的女性相比，体重增加模式不同。因此，本研究旨在确定 BMI 为 40 kg/m2 或以上的女性与妊娠期体重增加 (GWG) 相关的特征。方法 对 2009 年至 2015 年间 BMI 为 40 kg/m2 或以上且接受产前健康生活方式服务的单胎妊娠女性进行回顾性队列分析 (n = 735)。GWG 的计算方法是从最终记录的妊娠体重中减去第一次产前预约时的体重，前提是最终体重是从至少妊娠 34 + 0 周开始记录的。采用单变量和多元线性回归分析来确定 GWG 与不同母婴特征之间的关联。结果 BMI 为 40 kg/m2 或以上的女性平均 GWG 为 6.0 (±7.1)kg。多元回归显示 GWG 随着 BMI 的增加和胎次的增加而减少。其他社会人口因素也与 GWG 显着相关，在那些贫困程度较高的老年妇女和非英国白人女性中，最高的家庭职业是体力劳动，GWG 较高。结论 这组 BMI 为 40 kg/m2 或以上的女性的 GWG 符合医学研究所的建议。使用结合生物、心理和社会生态因素的 GWG 管理系统方法非常重要。