Maternal obesity and the risk of infant death in the United States.
Maternal obesity and the risk of infant death in the United States.
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DOI：
10.1097/ede.0b013e3181878645
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发表时间：
2009-01
期刊：
影响因子：
--
通讯作者：
Rogan WJ
中科院分区：
文献类型：
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作者：
Chen A;Feresu SA;Fernandez C;Rogan WJ
母亲肥胖（定义为孕前体重指数[BMI] ≥30 kg/m2）与新生儿死亡风险增加相关。其与婴儿死亡、新生儿后期死亡和特定原因婴儿死亡的关系尚不明确。我们利用1988年美国国家母婴健康调查数据研究了母亲肥胖与婴儿死亡风险之间的关系。应用SUDAAN软件对4265例婴儿死亡和7293例对照进行病例对照分析。自我报告的孕前BMI和体重增加被用于初步分析，而医疗记录中的体重变量被用于4308名妇女的子集。与正常体重妇女（孕前BMI = 18.5-24.9 kg/m2）相比，肥胖妇女在怀孕期间体重增加0.30 - 0.44 kg/wk，新生儿死亡和婴儿死亡的风险增加。对于妊娠期体重增加<0.15、0.15 - 0.29、0.30 - 0.44和≥0.45 kg/wk的肥胖妇女，婴儿死亡的校正比值比为1.75（95%置信区间= 1.28-2.39）、1.42（1.07-1.89）、1.59（1.00-2.51）和2.87（1.98-4.16）。怀孕期间体重增加很少的非肥胖妇女也有较高的婴儿死亡风险。从医疗记录中获得体重信息的子集在记录的孕前BMI和体重增加方面有相似的结果。母亲肥胖与因妊娠并发症或与妊娠期短和未指明的低出生体重相关的疾病导致的新生儿死亡相关。产妇肥胖与婴儿死亡，主要是新生儿死亡的总体风险增加有关。
Maternal obesity (defined as prepregnancy body mass index [BMI] ≥30 kg/m2) is associated with increased risk of neonatal death. Its association with infant death, postneonatal death, and cause-specific infant death is less well-characterized. We studied the association between maternal obesity and the risk of infant death by using 1988 US National Maternal and Infant Health Survey data. A case-control analysis of 4265 infant deaths and 7293 controls was conducted using SUDAAN software. Self-reported prepregnancy BMI and weight gain were used in the primary analysis, whereas weight variables in medical records were used in a subset of 4308 women. Compared with normal weight women (prepregnancy BMI = 18.5–24.9 kg/m2) who gained 0.30 to 0.44 kg/wk during pregnancy, obese women had increased risk of neonatal death and overall infant death. For obese women who had weight gain during pregnancy of <0.15, 0.15 to 0.29, 0.30 to 0.44, and ≥0.45 kg/wk, the adjusted odds ratios of infant death were 1.75 (95% confidence interval = 1.28–2.39), 1.42 (1.07–1.89), 1.59 (1.00–2.51), and 2.87 (1.98–4.16), respectively. Nonobese women with very low weight gain during pregnancy also had a higher risk of infant death. The subset with weight information from medical records had similar results for recorded prepregnancy BMI and weight gain. Maternal obesity was associated with neonatal death from pregnancy complications or disorders relating to short gestation and unspecified low birth weight. Maternal obesity is associated with increased overall risk of infant death, mainly neonatal death.