Women's prepregnancy underweight as a risk factor for preterm birth: a retrospective study.
Women's prepregnancy underweight as a risk factor for preterm birth: a retrospective study.
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DOI：
10.1111/1471-0528.14027
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发表时间：
2016-11
期刊：
影响因子：
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通讯作者：
March of Dimes Prematurity Research Center at Stanford University School of Medicine
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文献类型：
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作者：
Girsen AI;Mayo JA;Carmichael SL;Phibbs CS;Shachar BZ;Stevenson DK;Lyell DJ;Shaw GM;Gould JB;March of Dimes Prematurity Research Center at Stanford University School of Medicine
调查已知的早产因素（PTB）按产妇体重不足的严重程度的分布情况；调查体重不足严重程度与 PTB 之间的风险调整关系，并评估这种关系是否因胎龄而异。回顾性队列研究。美国加利福尼亚州。对 2007 年至 2010 年加州 950,356 例分娩的产妇相关医院和出生证明记录进行了分析。对孕前体重指数（BMI）体重不足（<18.5 kg/m2）或正常（18.50-24.99 kg/m2）的妇女的单胎活产进行了分析。 BMI 过低进一步分为：重度 (<16.00)、中度 (16.00–16.99) 或轻度 (17.00–18.49)。 PTB 分为 22-27、28-31、32-36 或 <37 周（与 37-41 周相比）。使用调整后的多变量泊松回归模型来估计 PTB 的相对风险。 PTB 风险。 72,686 名 (7.6%) 女性体重不足。体重不足严重程度的增加与 PTB 百分比的增加相关：轻度体重不足为 7.8% (n=4421)，中度体重不足为 9.0% (n=1001)，严重体重不足为 10.2% (475)。调整后的 PTB 相对风险也显着增加：轻度体重不足的 aRR=1.22 (95%CI: 1.19–1.26)，中度体重不足的 aRR=1.41 (95%CI: 1.32–1.50)，严重体重不足的 aRR=1.61 (95%CI: 1.47–1.76)。这些发现在自发性 PTB、有医学指征的 PTB 和孕龄分组中相似。母亲孕前体重过轻的严重程度增加与 <37 周时风险调整后 PTB 的增加相关。这种增加的风险在自然分娩和有医学指征的分娩以及妊娠 28-31 周和 32-36 周的早产中具有相似的程度。
To investigate the distribution of known factors for preterm birth (PTB) by severity of maternal underweight; to investigate the risk adjusted relationship between severity of underweight and PTB and to assess if the relationship differed by gestational age. Retrospective cohort study. State of California, USA. Maternally linked hospital and birth certificate records of 950,356 California deliveries in 2007–2010 were analyzed. Singleton live births of women whose pre-pregnancy body mass index (BMI) was underweight (<18.5 kg/m2) or normal (18.50–24.99 kg/m2) were analyzed. Underweight BMI was further categorized as: severe (<16.00), moderate (16.00–16.99) or mild (17.00–18.49). PTB was grouped as 22–27, 28–31, 32–36 or <37 weeks (compared with 37–41 weeks). Adjusted multivariable Poisson regression modeling was used to estimate relative risk for PTB. Risk of PTB. 72,686 (7.6%) women were underweight. Increasing severity of underweight was associated with increasing percent PTB: 7.8% (n=4421) in mild, 9.0% (n=1001) in moderate and 10.2% (475) in severe underweight. The adjusted relative risk of PTB also significantly increased: aRR=1.22 (95%CI: 1.19–1.26) in mild, aRR=1.41 (95%CI: 1.32–1.50) in moderate and aRR=1.61 (95%CI: 1.47–1.76) in severe underweight. These findings were similar in spontaneous PTB, medically indicated PTB, and the gestational age groupings. Increasing severity of maternal pre-pregnancy underweight BMI was associated with increasing risk adjusted PTB at <37 weeks. This increasing risk was of similar magnitude in spontaneous and medically indicated births and in preterm delivery at 28–31 and at 32–36 weeks of gestation.