Association of Pre-Pregnancy Body Mass Index and Gestational Weight Gain with Preterm Births and Fetal Size: an Observational Study from Lebanon
Association of Pre-Pregnancy Body Mass Index and Gestational Weight Gain with Preterm Births and Fetal Size: an Observational Study from Lebanon
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DOI：
10.1111/ppe.12249
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发表时间：
2016-01-01
影响因子：
2.8
通讯作者：
Yunis, Khalid A.
中科院分区：
文献类型：
--
作者：
El Rafei, Rym;Abbas, Hussein A.;Yunis, Khalid A.
背景资料：据报道，孕前体重指数（BMI）和妊娠期体重增加（GWG）会影响早产（PTB）率和新生儿大小。大多数研究是在发达国家进行的，尽管PTB和不良妊娠结局在发展中国家更常见。本研究的目的是阐明关联的孕前BMI和GWG的发生PTB和次优胎儿大小在黎巴嫩。方法：这是一项回顾性队列研究，使用医院为基础的登记册，涵盖35%的出生在黎巴嫩之间的2001年和2012年。通过病历和访谈收集了来自32家医院的170428例孕妇的数据。在调整混杂因素后，体重过轻的妇女发生极早产的几率增加[比值比（OR）1.58，95%置信区间（CI）1.16，2.14]，早产（OR 1.42，95% CI 1.28，1.58）和小于胎龄儿（SGA）（OR 1.50，95% CI 1.37，1.63）新生儿。当用GWG分析BMI时，只有SGA在低GWG的体重过轻妇女中仍然显著。对于所有BMI组，低GWG对大胎龄儿（LGA）有保护作用，而高GWG增加LGA的几率。低（OR 1.25，95%CI 1.15，1.35）和高（OR 1.43，95%CI 1.32，1.55）GWG均增加正常体重妇女发生PTB的风险。超重women.Conclusions：高GWG增加LGA的所有群体和PTB的正常体重和超重妇女的风险，而低GWG增加SGA和PTB的风险。鉴于中等收入/发展中国家关于怀孕期间体重增加模式的研究不多，本研究的结果可能有助于孕前咨询，重点是最佳孕前BMI和怀孕期间适当体重增加的重要性。
Background: Pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) are reported to impact the preterm birth (PTB) rate and newborn size. Most studies have been conducted in developed countries, although PTB and adverse pregnancy outcomes are more frequent in the developing world. The aim of this study is to elucidate the association of pre-pregnancy BMI and GWG on the occurrence of PTB and sub-optimal fetal size in Lebanon.Methods: This is a retrospective cohort study using a hospital-based register covering 35% of births in Lebanon between 2001 and 2012. Data were collected on 170 428 pregnancies from 32 hospitals using medical records and interviews.Results: After adjusting for confounders, underweight women had increased odds of having very preterm [odds ratio (OR) 1.58, 95% confidence interval (CI) 1.16, 2.14], preterm (OR 1.42, 95% CI 1.28, 1.58), and small for gestational age (SGA) (OR 1.50, 95% CI 1.37, 1.63) neonates. When BMI was analysed with GWG, only SGA remained significant in underweight women with low GWG. For all BMI groups, low GWG was protective against large for gestational age (LGA) and high GWG increased the odds of LGA. GWG, both low (OR 1.25, 95% CI 1.15, 1.35) and high (OR 1.43, 95% CI 1.32, 1.55) increased the risk of PTB in normal weight women. The same result was obtained for overweight women.Conclusions: High GWG increased the risk of LGA for all groups and PTB in normal weight and overweight women, whereas low GWG increased the risk of SGA and PTB. Given that there are not many studies from middle income/developing countries on patterns of weight gain during pregnancy, findings from this study may help with pre-conception counselling with emphasis on the importance of an optimal pre-pregnancy BMI and appropriate weight gain during pregnancy.