The Impact of Maternal Obesity and Race/Ethnicity on Perinatal Outcomes: Independent and Joint Effects
The Impact of Maternal Obesity and Race/Ethnicity on Perinatal Outcomes: Independent and Joint Effects
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DOI：
10.1002/oby.21532
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发表时间：
2016-07-01
期刊：
影响因子：
6.9
通讯作者：
Caughey, Aaron B.
中科院分区：
文献类型：
--
作者：
Snowden, Jonathan M.;Mission, John F.;Caughey, Aaron B.
目的：研究母亲种族/民族和肥胖对包括先兆子痫、低出生体重和巨大儿在内的不良出生结局的独立和联合影响。方法：使用生命记录和索赔数据对2007年加州出生的所有婴儿进行回顾性队列研究。结果：与正常体重的白人女性相比，正常体重的种族/少数民族女性比正常体重的白人女性有更高的风险(例如，非裔美国女性，经调整的先兆子痫优势比[AOR]1.60，95%可信区间[CI]：1.48~1.74 vs白人女性)。然而，BMI升高通常不会带来额外的风险(例如，先兆子痫AOR比较超重的非裔美国女性和超重的白人女性，1.17，95%CI：0.89-1.54)。肥胖是低出生体重的危险因素，只有白人妇女(超重比，1.24，95%CI：1.04-1.49与正常体重的白人妇女相比)，而不是种族/少数民族妇女(例如，非裔美国人妇女，0.95，95%CI：0.83-1.08)。结论：这些发现增加了我们对母亲种族/民族、BMI和围产儿结局之间相互作用的细微差别。虽然BMI/不良结局梯度在种族/少数民族妇女中似乎较弱，但这反映了各种体型的种族/少数民族妇女总体风险增加。
Objective: Independent and joint impacts of maternal race/ethnicity and obesity on adverse birth outcomes, including pre-eclampsia, low birth weight, and macrosomia, were characterized.Methods: Retrospective cohort study of all 2007 California births was conducted using vital records and claims data. Maternal race/ethnicity and maternal body mass index (BMI) were the key exposures; their independent and joint impact on outcomes using regression models was analyzed.Results: Racial/ethnic minority women of normal weight generally had higher risk as compared with white women of normal weight (e.g., African-American women, pre-eclampsia adjusted odds ratio [aOR] 1.60, 95% confidence interval [CI]: 1.48-1.74 vs. white women). However, elevated BMI did not usually confer additional risk (e.g.,pre-eclampsia aOR comparing African-American women with excess weight with white women with excess weight, 1.17, 95% CI: 0.89-1.54). Obesity was a risk factor for low birth weight only among white women (excess weight aOR, 1.24, 95% CI: 1.04-1.49 vs. white women of normal weight) and not among racial/ethnic minority women (e.g., African-American women, 0.95, 95% CI: 0.83-1.08).Conclusions: These findings add nuance to our understanding of the interplay between maternal race/ethnicity, BMI, and perinatal outcomes. While the BMI/adverse outcome gradient appears weaker in racial/ethnic minority women, this reflects the overall risk increase in racial/ethnic minority women of all body sizes.