Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study: associations with maternal body mass index
Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Study: associations with maternal body mass index
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DOI：
10.1111/j.1471-0528.2009.02486.x
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发表时间：
2010-04-01
影响因子：
5.8
通讯作者：
Metzger, B. E.
中科院分区：
文献类型：
--
作者：
Metzger, B. E.
ObjectiveTo determine whether higher maternal body mass index（BMI），independent of maternal hyperemia，is associated with adverse pregnancy outcomes.DesignObservational cohort study.SettingFifteen centers in nine countries.PopulationEligible pregnancy women.MethodsA 75-g 2-hour oral glucose tolerance test（OGTT）was performed between 24 and 32 wk of pregnancy in all participants.母亲的BMI是根据OGTT时测量的身高和体重计算的。通过测量胎儿皮褶厚度和计算体脂百分比来评估胎儿肥胖。采用多元logistic回归分析评估母亲BMI和妊娠结局之间的关系，并调整潜在的混杂因素。主要结局指标预先定义的主要结局为出生体重>第90百分位数，初次剖腹产，临床新生儿低血糖和脐带血清C肽>第90百分位数。次要结局包括先兆子痫、早产结果在23316名盲法受试者中，对照母体高脂血症和其他潜在混杂因素，母亲BMI较高与（最高BMI类别{>= 42.0 kg/m2}与最低BMI类别{< 22.6 kg/m2}的比值比[95%置信区间]），出生体重>第90百分位数的频率增加（3.52 [2.48-5.00]）和体脂百分比>第90百分位数（3.28 [2.28-4.71]）、剖腹产（2.23 [1.66-2.99]）、脐带C肽>第90百分位数（2.33 [1.58-3.43]）和先兆子痫（14.14 [9.44-21.17]）。BMI较高的早产发生率较低（0.48 [0.31-0.74]）。与胎儿大小的协会往往高原在最高的产妇BMI categorization.ConclusionHigher产妇BMI，独立的产妇高血压，是强烈相关的频率增加的妊娠并发症，特别是那些与胎儿过度生长和肥胖和先兆子痫。
ObjectiveTo determine whether higher maternal body mass index (BMI), independent of maternal glycaemia, is associated with adverse pregnancy outcomes.DesignObservational cohort study.SettingFifteen centres in nine countries.PopulationEligible pregnant women.MethodsA 75-g 2-hour oral glucose tolerance test (OGTT) was performed between 24 and 32 weeks of gestation in all participants. Maternal BMI was calculated from height and weight measured at the OGTT. Fetal adiposity was assessed using skinfold measurements and percentage of body fat was calculated. Associations between maternal BMI and pregnancy outcomes were assessed using multiple logistic regression analyses, with adjustment for potential confounders.Main outcome measuresPredefined primary outcomes were birthweight > 90th percentile, primary caesarean section, clinical neonatal hypoglycaemia and cord serum C-peptide > 90th percentile. Secondary outcomes included pre-eclampsia, preterm delivery (before 37 weeks) and percentage of body fat > 90th percentile.ResultsAmong 23 316 blinded participants, with control for maternal glycaemia and other potential confounders, higher maternal BMI was associated (odds ratio [95% confidence interval] for highest {>= 42.0 kg/m2} versus lowest {< 22.6 kg/m2} BMI categories) with increased frequency of birthweight > 90th percentile (3.52 [2.48-5.00]) and percentage of body fat > 90th percentile (3.28 [2.28-4.71]), caesarean section (2.23 [1.66-2.99]), cord C-peptide > 90th percentile (2.33 [1.58-3.43]) and pre-eclampsia (14.14 [9.44-21.17]). Preterm delivery was less frequent with higher BMI (0.48 [0.31-0.74]). Associations with fetal size tended to plateau in the highest maternal BMI categories.ConclusionHigher maternal BMI, independent of maternal glycaemia, is strongly associated with increased frequency of pregnancy complications, in particular those related to excess fetal growth and adiposity and to pre-eclampsia.