Maternal Obesity During Pregnancy Associates With Premature Mortality and Major Cardiovascular Events in Later Life
Maternal Obesity During Pregnancy Associates With Premature Mortality and Major Cardiovascular Events in Later Life
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DOI：
10.1161/hypertensionaha.115.05920
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发表时间：
2015-11-01
期刊：
影响因子：
8.3
通讯作者：
Reynolds, Rebecca M.
中科院分区：
文献类型：
--
作者：
Lee, Kuan Ken;Raja, Edwin A.;Reynolds, Rebecca M.
每5名孕妇中就有一人肥胖，但对以后健康的影响尚不清楚。我们的目的是确定孕妇怀孕期间肥胖是否与早逝和晚年主要心血管事件的增加相关。阿伯丁产妇和新生儿数据库中1950至1976年间生育第一个孩子的妇女(n=18 873人)的分娩记录与国家死亡登记、苏格兰和苏格兰发病率记录相关联。首次产前就诊时母亲肥胖对死亡和心血管事件入院的影响采用COX比例风险回归分析，以比较体重不足、超重或肥胖的母亲与正常体重指数(BMI)的母亲的结局。中位随访期为73年。在调整了社会经济状况、吸烟、BMI测量时的妊娠、先兆子痫和低出生体重(危险比为1.35；95%可信区间为1.02-1.77)后，妊娠期肥胖(BMI和GT；30 kg/m(2))女性的全因死亡率高于正常BMI。在调整后的模型中，与正常体重指数母亲相比，超重和肥胖母亲因心血管事件住院的风险增加(1.16；1.06-1.27和1.26；1.01-1.57)。调整产次风险比基本不变(死亡率：1.43，1.09-1.88；心血管事件超重：1.17，1.07-1.29；肥胖：1.30，1.04-1.62)。总而言之，母亲肥胖与过早死亡和心血管疾病的风险增加有关。怀孕和产后早期可能是一个机会，可以进行干预，以确定肥胖并减少其不良后果。
One in 5 pregnant women is obese but the impact on later health is unknown. We aimed to determine whether maternal obesity during pregnancy associates with increased premature mortality and later life major cardiovascular events. Maternity records of women who gave birth to their first child between 1950 and 1976 (n=18 873) from the Aberdeen Maternity and Neonatal databank were linked to the National Register of Deaths, Scotland and Scottish Morbidity Record. The effect of maternal obesity at first antenatal visit on death and hospital admissions for cardiovascular events was tested using time-to-event analysis with Cox proportional hazard regression to compare outcomes of mothers in underweight, overweight, or obese body mass index (BMI) categories compared with normal BMI. Median follow-up was at 73 years. All-cause mortality was increased in women who were obese during pregnancy (BMI>30 kg/m(2)) versus normal BMI after adjustment for socioeconomic status, smoking, gestation at BMI measurement, preeclampsia, and low birth weight (hazard ratio, 1.35; 95% confidence interval, 1.02-1.77). In adjusted models, overweight and obese mothers had increased risk of hospital admission for a cardiovascular event (1.16; 1.06-1.27 and 1.26; 1.01-1.57) compared with normal BMI mothers. Adjustment for parity largely unchanged the hazard ratios (mortality: 1.43, 1.09-1.88; cardiovascular events overweight: 1.17, 1.07-1.29; and obese: 1.30, 1.04-1.62). In conclusion, maternal obesity is associated with increased risk of premature death and cardiovascular disease. Pregnancy and early postpartum could represent an opportunity for interventions to identify obesity and reduce its adverse consequences.