Gestational weight gain Z-score to evaluate the weight gain during pregnancy of assisted reproductive twin pregnancy and its influence on pregnancy outcome
WANG Yanxia, WANG Wendi, JIANG Xiaohui, ZHANG Chunhua, XU Xiaoying, YI Bin, MENG Zhaoyan, WANG Wenling
Gansu Provincial Maternity and Child-care Hospital, Gansu 730050, China
Abstract:Objective To evaluate the effect of gestational weight gain (GWG) Z-score on adverse pregnancy outcomes of twin pregnancy women who have succeeded in assisted reproductive technology (ART).Methods A prospective ART maternal cohort established, twin pregnant women who conceived by ART and had no history of basal metabolic diseases were selected from the Perinatal Medicine Center of Gansu Province Maternal and Child Health Hospital. The mid-trimester life behavior questionnaire was investigated, and GWG, record pregnancy examination, complications and pregnancy outcomes were surveyed in follow-up. GWG (kg) is converted into the standardized Z score according to gestational age, and is divided into three groups:insufficient weight gain, appropriate weight gain, and excessive weight gain as Z score <1, -1 to +1, >1. The Logistic regression was used to evaluate the influence of GWG Z-score on adverse pregnancy outcomes.Results A total of 841 women with ART twin pregnancy were included. After controlled confounding factors, the insufficient GWG (Z score <-1) is the protective factor for cesarean section (OR=0.39, 95%CI:0.17-0.92) and pregnancy-induced hypertension (OR=0.29, 95% CI:0.09-0.97), and is the risk factor for preterm birth (OR=3.12, 95%CI:1.53-6.38 ) and the low average birth weight (OR=2.06, 95%CI:1.16-3.68). The sufficient GWG (Z score >1) is the risk factor for premature rupture of membranes (OR=2.05, 95%CI:1.09-3.84), premature delivery (OR=2.49, 95%CI:1.38-4.50), and pregnancy-induced hypertension (OR=2.92, 95%CI:1.66-5.31).Conclusion Z score can be used as a new indicator to evaluate the GWG of Chinese twin pregnancy women with suitable basic weight. When Z score <-1 or Z score>1, the risk of adverse pregnancy outcomes increased significantly. The Z score method is convenient, reliable, and easy to clinically use.
王燕侠, 王文第, 蒋小慧, 张春花, 许晓英, 易彬, 孟照琰, 王文玲. 孕期增重Z评分评估辅助生殖双胎妊娠妇女孕期增重程度及对妊娠结局的影响[J]. 中国生育健康杂志, 2022, 33(6): 532-537.
WANG Yanxia, WANG Wendi, JIANG Xiaohui, ZHANG Chunhua, XU Xiaoying, YI Bin, MENG Zhaoyan, WANG Wenling. Gestational weight gain Z-score to evaluate the weight gain during pregnancy of assisted reproductive twin pregnancy and its influence on pregnancy outcome. Chinese Journal of Reproductive Health, 2022, 33(6): 532-537.
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