Risk for spontaneous preterm delivery by combined body mass index and gestational weight gain patterns
Risk for spontaneous preterm delivery by combined body mass index and gestational weight gain patterns
复制标题
DOI：
10.1080/00016349808565807
复制
发表时间：
1998-01-01
影响因子：
4.3
通讯作者：
Di Mario, M
中科院分区：
文献类型：
--
作者：
Spinillo, A;Capuzzo, E;Di Mario, M
研究孕妇人体测量因素是否相互作用或与其他危险因素相互作用，从而改变自发性早产的风险。我们对230例妊娠24 ~ 35周胎膜完整的自发性早产和460例对照足月分娩进行了病例对照研究。所有患者均在同一机构接受产前护理。Logistic回归分析用于检验可能的相互作用，调整潜在的混杂因素。孕前体重指数小于或等于19.5 Kg/m（2）（比值比（OR）=1.68，95%置信区间（CI）=1.20-2.38），且在妊娠中期和妊娠晚期体重增加率小于或等于0.37 Kg/周（OR=2.4，95%CI =1.69-3.32）与自发性早产的风险增加有关。与体重指数>19.5的患者相比，体重指数小于或等于19.5的患者（OR=5.63，95%CI =2.35-13.8）中与中晚期体重增量低相关的自发性早产风险更大（OR=2.45，95%CI =1.60-3.75，相互作用的校正p值=0.05）。与母亲孕前体重小于或等于48 Kg相关的自发性早产的风险在吸烟者中（OR=5.81，95%CI =1.60-22.9）高于非吸烟者（OR=2.4，95%CI =1.53-3.74：相互作用的校正p值=0.05）。与妊娠前体重指数低的患者相比，妊娠中期和妊娠晚期体重增加率低的患者发生自发性早产的风险更大。这项研究的结果支持了与体重指数较高的患者相比，体重指数较低的患者体重增加率增加的建议。
Background To investigate whether maternal anthropometric factors interact with one another or with other risk factors, thus modifying the risk of spontaneous preterm delivery.Methods. We carried out a case-control study of 230 spontaneous preterm births with intact membranes between 24 and 35 weeks gestation and 460 control term births. All the patients had prenatal care at the same institution. Logistic regression analysis was used to test for possible interactions adjusting for potential confounders.Results. A pre-pregnancy body mass index less than or equal to 19.5 Kg/m(2) (odds ratio (OR)=1.68, 95% confidence interval (CI)=1.20-2.38) and a rate of weight gain less than or equal to 0.37 Kg/week during the second and third trimesters (OR=2.4, 95% CI=1.69-3.32) were associated with an increased risk of spontaneous preterm delivery. The risk of spontaneous preterm delivery associated with a low second/third trimester weight gain was greater among patients with a body mass index less than or equal to 19.5 (OR=5.63, 95% CI=2.35-13.8) compared to those with a body mass index >19.5 (OR=2.45, 95% CI=1.60-3.75, adjusted p value for interaction=0.05). The risk of spontaneous premature delivery associated with a maternal pre-pregnancy weight less than or equal to 48 Kg was higher among smokers (OR=5.81, 95% CI=1.60-22.9) than among non-smokers (OR=2.4, 95% CI=1.53-3.74: adjusted p value for interaction=0.05).Conclusions. The risk of spontaneous preterm delivery associated with a low pre-pregnancy body mass index is greater among patients with low rate of gestational weight gain during the second and third trimesters compared to those with a higher rate. The results of this study support the recommendation for increased rates of weight gain to patients with low body mass index compared to those with a higher body mass index.