Is maternal weight gain between pregnancies associated with risk of large-for-gestational age birth? Analysis of a UK population-based cohort
Is maternal weight gain between pregnancies associated with risk of large-for-gestational age birth? Analysis of a UK population-based cohort
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两次怀孕期间母亲体重增加是否与大于胎龄分娩的风险相关？
DOI：
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
N. Alwan
中科院分区：
文献类型：
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作者：
N. Ziauddeen;Sam Wilding;P. Roderick;N. Macklon;N. Alwan
目的 孕期母亲超重和肥胖会增加大于胎龄（LGA）出生和儿童肥胖的风险。我们的目的是调查随后怀孕期间母亲体重变化与 LGA 出生风险之间的关系。设计基于人群的队列。设置 2003 年 1 月至 2017 年 9 月期间在英国南安普顿大学医院定期收集产前保健数据。参与者对前两次连续单胎活产妊娠的妇女的健康记录进行了分析（n=15 940）。主要结局指标是第二次妊娠时 LGA 风险、复发性 LGA 风险和新产 LGA 风险。结果 在 15940 名女性中，怀孕期间体重减轻了 16.0%，体重增加了 47.7%（≥1kg/m2）。怀孕期间体重减轻 ≥1 kg/m2 (12.4%) 且体重稳定在 -1 至 1 kg/m2 (11.9%) 的女性所生婴儿的 LGA 比例较低，而体重增加 1-3 和 ≥3 kg/m2 的女性所生婴儿的 LGA 比例分别为 13.5% 和 15.9%。体重增加≥3kg/m2 的肥胖女性比例最高（21.2%）。如果体重减轻≥1kg/m2，超重女性在第二次妊娠时再次发生 LGA 的风险会降低（调整后相对风险 (aRR) 0.69，95%CI 0.48 至 0.97），而体重增加 ≥3kg/m2 的超重女性在第一次妊娠非 LGA 分娩后，发生新 LGA 的风险会增加（aRR 1.35，95%CI） 1.05 至 1.75）。体重增加的正常体重女性在第二次妊娠时出现新 LGA 的风险也增加（体重增加 1-3kg/m2 时，aRR 1.26，95%CI 1.06 至 1.50；体重增加 ≥3kg/m2 时，aRR 1.34，95%CI 1.09 至 1.65）。结论 对于超重女性，LGA 出生后体重减轻与下次怀孕时 LGA 风险降低相关，而孕间体重增加与新 LGA 风险增加相关。防止怀孕期间体重增加是实现更好的母亲和后代结局的重要措施。
Objective Maternal overweight and obesity during pregnancy increases the risk of large-for-gestational age (LGA) birth and childhood obesity. We aimed to investigate the association between maternal weight change between subsequent pregnancies and risk of having a LGA birth. Design Population-based cohort. Setting Routinely collected antenatal healthcare data between January 2003 and September 2017 at University Hospital Southampton, England. Participants Health records of women with their first two consecutive singleton live-birth pregnancies were analysed (n=15 940). Primary outcome measure Risk of LGA, recurrent LGA and new LGA births in the second pregnancy. Results Of the 15 940 women, 16.0% lost and 47.7% gained weight (≥1 kg/m2) between pregnancies. A lower proportion of babies born to women who lost ≥1 kg/m2 (12.4%) and remained weight stable between −1 and 1 kg/m2 (11.9%) between pregnancies were LGA compared with 13.5% and 15.9% in women who gained 1–3 and ≥3 kg/m2, respectively. The highest proportion was in obese women who gained ≥3 kg/m2 (21.2%). Overweight women had a reduced risk of recurrent LGA in the second pregnancy if they lost ≥1 kg/m2 (adjusted relative risk (aRR) 0.69, 95% CI 0.48 to 0.97) whereas overweight women who gained ≥3 kg/m2 were at increased risk of new LGA after having a non-LGA birth in their first pregnancy (aRR 1.35, 95% CI 1.05 to 1.75). Normal-weight women who gained weight were also at increased risk of new LGA in the second pregnancy (aRR 1.26, 95% CI 1.06 to 1.50 with gain of 1–3 kg/m2 and aRR 1.34, 95% CI 1.09 to 1.65 with gain of ≥3 kg/m2). Conclusions Losing weight after an LGA birth was associated with a reduced LGA risk in the next pregnancy in overweight women, while interpregnancy weight gain was associated with an increased new LGA risk. Preventing weight gain between pregnancies is an important measure to achieve better maternal and offspring outcomes.
DOI：
10.1016/s0140-6736(18)30311-8
发表时间：
2018-05-05
期刊：
Lancet (London, England)
影响因子：
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作者：
Stephenson J;Heslehurst N;Hall J;Schoenaker DAJM;Hutchinson J;Cade JE;Poston L;Barrett G;Crozier SR;Barker M;Kumaran K;Yajnik CS;Baird J;Mishra GD
通讯作者：
Mishra GD
影响因子：
37.8
作者：
Curhan, GC;Chertow, GM;Stampfer, MJ
通讯作者：
Stampfer, MJ
影响因子：
37.8
作者：
Curhan, GC;Willett, WC;Stampfer, MJ
通讯作者：
Stampfer, MJ