Integrating multiple lines of evidence to assess the effects of maternal BMI on pregnancy and perinatal outcomes.
Integrating multiple lines of evidence to assess the effects of maternal BMI on pregnancy and perinatal outcomes.
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整合多条证据线以评估母体BMI对妊娠和围产期结局的影响。
DOI：
10.1186/s12916-023-03167-0
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发表时间：
2024-01-29
期刊：
影响因子：
9.3
通讯作者：
Lawlor, Deborah A.
中科院分区：
文献类型：
--
作者：
Borges, Maria Carolina;Clayton, Gemma L.;Freathy, Rachel M.;Felix, Janine F.;Fernandez-Sanles, Alba;Soares, Ana Goncalves;Kilpi, Fanny;Yang, Qian;Mceachan, Rosemary R. C.;Richmond, Rebecca C.;Liu, Xueping;Skotte, Line;Irizar, Amaia;Hattersley, Andrew T.;Bodinier, Barbara;Scholtens, Denise M.;Nohr, Ellen A.;Bond, Tom A.;Hayes, M. Geoffrey;West, Jane;Tyrrell, Jessica;Wright, John;Bouchard, Luigi;Murcia, Mario;Bustamante, Mariona;Chadeau-Hyam, Marc;Jarvelin, Marjo-Riitta;Vrijheid, Martine;Perron, Patrice;Magnus, Per;Gaillard, Romy;Jaddoe, Vincent W. V.;Lowe, William L.;Feenstra, Bjarke;Hivert, Marie-France;Sorensen, Thorkild I. A.;Haberg, Siri E.;Serbert, Sylvain;Magnus, Maria;Lawlor, Deborah A.
较高的母亲孕前体重指数（BMI）与不良妊娠和围产期结局相关。然而，这些关联是否存在因果关系仍不清楚。我们通过整合三种不同方法（即多变量回归、孟德尔随机化和父亲阴性对照分析）的证据（包括来自超过 400,000 名女性的数据），探讨了母亲孕前/孕早期 BMI 与 20 次妊娠和围产期结局的关系。所有三种分析方法都支持母亲 BMI 较高与母亲贫血、生下小于胎龄儿和开始母乳喂养的几率较低之间的关联，但妊娠期高血压疾病、妊娠期高血压、先兆子痫、妊娠糖尿病、产前胎膜破裂、引产、剖腹产、大于胎龄、高出生体重、1 分钟阿普加评分低和新生儿强化的几率较高。护理单位入院。例如，在多变量回归（OR = 1.67；95% CI = 1.63，BMI每标准单位1.70）和孟德尔随机化（OR = 1.59；95% CI = 1.38，1.83）中，较高的母亲BMI与较高的妊娠期高血压风险相关，而父亲则没有发现这种情况。 BMI（OR = 1.01；95% CI = 0.98，1.04）。研究结果并不支持母亲体重指数与围产期抑郁症之间的关系。对于其他结果，由于所应用的方法不一致或孟德尔随机化的效果估计严重不精确，证据尚无定论。我们的研究结果支持母亲孕前/孕早期 BMI 对 20 种不良妊娠和围产期结局中的 14 种有因果作用。支持女性保持健康体重指数的孕前干预措施可能会减轻产科和新生儿并发症的负担。医学研究委员会、英国心脏基金会、欧洲研究委员会、美国国立卫生研究院、国家健康研究所、挪威研究委员会、威康信托基金。在线版本包含可在 10.1186/s12916-023-03167-0 获取的补充材料。
Higher maternal pre-pregnancy body mass index (BMI) is associated with adverse pregnancy and perinatal outcomes. However, whether these associations are causal remains unclear. We explored the relation of maternal pre-/early-pregnancy BMI with 20 pregnancy and perinatal outcomes by integrating evidence from three different approaches (i.e. multivariable regression, Mendelian randomisation, and paternal negative control analyses), including data from over 400,000 women. All three analytical approaches supported associations of higher maternal BMI with lower odds of maternal anaemia, delivering a small-for-gestational-age baby and initiating breastfeeding, but higher odds of hypertensive disorders of pregnancy, gestational hypertension, preeclampsia, gestational diabetes, pre-labour membrane rupture, induction of labour, caesarean section, large-for-gestational age, high birthweight, low Apgar score at 1 min, and neonatal intensive care unit admission. For example, higher maternal BMI was associated with higher risk of gestational hypertension in multivariable regression (OR = 1.67; 95% CI = 1.63, 1.70 per standard unit in BMI) and Mendelian randomisation (OR = 1.59; 95% CI = 1.38, 1.83), which was not seen for paternal BMI (OR = 1.01; 95% CI = 0.98, 1.04). Findings did not support a relation between maternal BMI and perinatal depression. For other outcomes, evidence was inconclusive due to inconsistencies across the applied approaches or substantial imprecision in effect estimates from Mendelian randomisation. Our findings support a causal role for maternal pre-/early-pregnancy BMI on 14 out of 20 adverse pregnancy and perinatal outcomes. Pre-conception interventions to support women maintaining a healthy BMI may reduce the burden of obstetric and neonatal complications. Medical Research Council, British Heart Foundation, European Research Council, National Institutes of Health, National Institute for Health Research, Research Council of Norway, Wellcome Trust. The online version contains supplementary material available at 10.1186/s12916-023-03167-0.
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影响因子：
64.8
作者：
Bycroft C;Freeman C;Petkova D;Band G;Elliott LT;Sharp K;Motyer A;Vukcevic D;Delaneau O;O'Connell J;Cortes A;Welsh S;Young A;Effingham M;McVean G;Leslie S;Allen N;Donnelly P;Marchini J
通讯作者：
Marchini J
影响因子：
2.1
作者：
Bowden J;Davey Smith G;Haycock PC;Burgess S
通讯作者：
Burgess S
影响因子：
2.4
作者：
Fenton TR;Kim JH
通讯作者：
Kim JH
影响因子：
7.2
作者：
Coolman, Marianne;de Groot, Christianne J. M.;Steegers, Eric A. P.
通讯作者：
Steegers, Eric A. P.
影响因子：
8.9
作者：
Heslehurst, N.;Simpson, H.;Summerbell, C. D.
通讯作者：
Summerbell, C. D.