Investigating the association between prepregnancy body mass index and adverse pregnancy outcomes: a large cohort study of 536 098 Chinese pregnant women in rural China.
Investigating the association between prepregnancy body mass index and adverse pregnancy outcomes: a large cohort study of 536 098 Chinese pregnant women in rural China.
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DOI：
10.1136/bmjopen-2016-011227
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发表时间：
2016-07-20
期刊：
影响因子：
2.9
通讯作者：
Sun L
中科院分区：
文献类型：
--
作者：
Pan Y;Zhang S;Wang Q;Shen H;Zhang Y;Li Y;Yan D;Sun L
怀孕前不健康的母亲体重会增加各种不良妊娠结局的风险。我们开展了一项营养调查，提供母亲孕前营养状况的基线数据，以便更好地了解孕前母亲体重指数（BMI）与不良妊娠结局之间的关系。一项大型、前瞻性、基于人群的队列研究。 2010-2012 年中国国家免费孕前健康检查项目（NFPHEP）的数据。对 2 120 131 名孕妇中的 536 098 名进行了评估。主要不良妊娠结局包括早产（PTB）、低出生体重（LBW）、自然流产（SM）、异位妊娠（EP）和死产（SB）。 χ2 检验用于比较 2010-2012 年期间每个 BMI 类别的患病率。采用单变量和多元逻辑回归分析来评估孕前 BMI 与各种不良妊娠结局之间的关联。 2010年至2012年间，平均BMI从21.31下降到21.16，体重不足发生率从10.40%上升到14.14%。年龄分层亚组分析表明，21-24岁女性的体重不足发生率从13.52%上升到17.02%，25-34岁女性的体重不足发生率从10.72%上升到13.71%。超重患病率从 9.84% 增加到 10.75%（25-34 岁），从 17.10% 增加到 19.20%（35-49 岁）。 25-34岁和35-49岁女性的肥胖率分别从2.17%增加到2.42%和4%增加到4.2%。孕前体重过轻与 PTB、LBW 和 SM 相关；超重女性的低体重风险增加；肥胖女性患 LBW、SM、EP 和 SB 的风险较高。虽然孕前平均体重指数下降，但大量人群中体重不足的患病率却显着增加。异常的孕前体重指数与不良妊娠结局的风险增加相关。最值得注意的是，中国农村地区体重不足的孕前妇女出现不良妊娠结局的风险似乎更大。
Unhealthy maternal weight before pregnancy increases the risk of various adverse pregnancy outcomes. We conducted a nutrition survey to provide baseline data on the prepregnant nutritional status of mothers in order to better understand the association between prepregnancy maternal body mass index (BMI) and adverse pregnancy outcomes. A large, prospective, population-based cohort study. Data from the National Free Preconception Health Examination Project (NFPHEP) in China during 2010–2012. 536 098 pregnant women out of 2 120 131 were evaluated. The primary adverse pregnancy outcomes included preterm birth (PTB), low birth weight (LBW), spontaneous miscarriage (SM), ectopic pregnancy (EP) and stillbirth (SB). A χ2 test was used to compare the prevalence of each BMI category during 2010–2012. Univariable and multiple logistic regression analyses were performed to assess the association between prepregnancy BMI and various adverse pregnancy outcomes. Between 2010 and 2012, the average BMI decreased from 21.31 to 21.16, while underweight prevalence increased from 10.40% to 14.14%. An age-stratified subgroup analysis indicated that the underweight prevalence increased from 13.52% to 17.02% among women aged 21–24 and from 10.72% to 13.71% among women aged 25–34. Overweight prevalence increased from 9.84% to 10.75% (25–34 years) and from 17.10% to 19.20% (35–49 years). Obesity prevalence increased from 2.17% to 2.42% and from 4% to 4.2% among women aged 25–34 and 35–49 respectively. Prepregnancy underweight was associated with PTB, LBW and SM; overweight women had an increased risk of LBW; obese women had a higher risk of LBW, SM, EP and SB. While the average prepregnancy BMI decreased, the prevalence of underweight individuals in a very large population significantly increased. The abnormal prepregnancy BMIs were associated with increased risks of adverse pregnancy outcomes. Most notably, underweight prepregnant women appeared to be at a greater risk of developing adverse pregnancy outcomes in China's rural areas.