Association between perinatal outcomes and maternal pre-pregnancy body mass index
Association between perinatal outcomes and maternal pre-pregnancy body mass index
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DOI：
10.1111/obr.12455
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发表时间：
2016-11-01
期刊：
影响因子：
8.9
通讯作者：
Wang, Z.
中科院分区：
文献类型：
--
作者：
Liu, P.;Xu, L.;Wang, Z.
Objectives量化孕产妇孕前体重指数（BMI）与围产期outcomes.MethodsWe系统回顾和收集了截至2015年8月31日发表的关于孕产妇孕前BMI与围产期结局的研究。结果共纳入60篇研究，涉及1,392,799例孕妇，其中肥胖孕妇占11.72%，超重孕妇占22.08%，正常体重孕妇占58.03%，体重不足孕妇占8.18%。当母亲超重或肥胖时，她们的婴儿比胎龄大的风险明显更高（OR分别为1.45，95%CI，1.29-1.63和1.88，95%CI，1.67-2.11），（OR分别为1.70，95%CI，1.55-1.87和2.92，95%CI，2.67-3.20），进入新生儿重症监护室（OR分别为1.29，95%CI，1.12-1.48和1.91，95%CI，1.60-2.29）和死产（OR分别为1.27，95%CI，1.18-1.36和1.81，95%CI，1.69-1.93）。当母亲体重不足时，她们的婴儿出现上述结果的风险较低。然而，体重过轻的母亲有更高的早产风险（OR，1.30，95%CI，1.13-1.49）和分娩小于胎龄儿（OR，1.67，95%CI，1.49-1.87）。重要的是，当母亲体重不足时，婴儿有更高的低出生体重风险（OR，1.67，95%CI，1.39-2.02）或肥胖结论超重或肥胖与死产、大于胎龄儿、巨大儿、新生儿重症监护室和LBW的入院率与早产、小于胎龄儿和LBW的风险增加相关。育龄妇女在怀孕前应保持正常的体重指数。
ObjectiveTo quantify the association between maternal pre-pregnancy body mass index (BMI) and perinatal outcomes.MethodsWe systematically reviewed and collected studies on maternal pre-pregnancy BMI and perinatal outcomes published up to 31 August 2015. For each study, we constructed separate two-by-two tables to calculate the odds ratios (ORs) and 95% confidence intervals (CI).ResultsA total of 60 studies involving 1,392,799 women were included, and the proportions of obesity, overweight, normal weight and underweight pregnant women were 11.72%, 22.08%, 58.03% and 8.18%, respectively. When mothers were overweight or obese, their infants had a significantly higher risk of being large for gestational age (OR, 1.45, 95%CI, 1.29-1.63 and 1.88, 95%CI, 1.67-2.11, respectively), having macrosomia (OR, 1.70, 95%CI, 1.55-1.87 and 2.92, 95%CI, 2.67-3.20, respectively), being admitted to the neonatal intensive care unit (OR, 1.29, 95%CI, 1.12-1.48 and 1.91, 95%CI, 1.60-2.29, respectively) and being stillborn (OR, 1.27, 95%CI, 1.18-1.36 and 1.81, 95%CI, 1.69-1.93, respectively). When mothers were underweight, their infants had a lower risk of the aforementioned outcomes. However, mothers who were underweight had a higher risk of preterm birth (OR, 1.30, 95%CI, 1.13-1.49) and delivering an infant small for gestational age (OR, 1.67, 95%CI, 1.49-1.87). Importantly, infants had a higher risk of having a low birth weight (LBW) when their mothers were underweight (OR, 1.67, 95%CI, 1.39-2.02) or obese (OR, 1.24, 95%CI, 1.09-1.41).ConclusionBeing overweight or obese was associated with an increased risk of still birth, large for gestational age, macrosomia, admission to the neonatal intensive care unit and LBW, while being underweight was associated with an increased risk of preterm birth, small for gestational age, and LBW. Women of childbearing age should maintain a normal body mass index before pregnancy.