Effect of gestational weight gain on preeclampsia among underweight women: A single tertiary referral center study in Japanese women
Effect of gestational weight gain on preeclampsia among underweight women: A single tertiary referral center study in Japanese women
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DOI：
10.1111/jog.15200
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发表时间：
2022-03-04
影响因子：
1.6
通讯作者：
Fujimori, Keiya
中科院分区：
文献类型：
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作者：
Kyozuka, Hyo;Jin, Toki;Fujimori, Keiya
目的探讨孕期体重增加对孕前体重指数< 18.5 kg/m妇女子痫前期的影响(2)。方法回顾性队列研究纳入2013年至2019年在Ohta Nishinouchi医院分娩的479名日本单胎妊娠、孕前体重指数< 18.5 kg/m(2)的女性。该研究包括22名（18名先兆子痫患者和4名妊娠期高血压患者）和457名有或没有妊娠期高血压疾病的患者。结果妊娠期高血压疾病患病率为4.6%，子痫前期患病率为3.8%。以妊娠期体重增加（连续变量）为参照，多元logistic回归结果显示，妊娠期体重增加过多增加了子痫前期（校正优势比为1.13,95%可信区间为1.00 ~ 1.28,p < 0.05）和妊娠期高血压疾病（校正优势比为1.15,95%可信区间为1.03 ~ 1.29,p < 0.05）的风险。根据受试者工作特征曲线分析（曲线下面积0.65,95%可信区间：0.50-0.80,p < 0.05），我们确定体重指数< 18.5 kg/m(2)的孕妇发生子痫前期体重增加的临界值为13.0 kg，敏感性为0.50，特异性为0.78。结论本研究提示体重过轻妇女孕期体重增加增加子痫前期风险，并为此类妇女孕期体重增加提供新的建议。对体重过轻妇女子痫前期发病机制的进一步研究是有必要的。
Aim To examine the effect of weight gain during pregnancy on preeclampsia among women with a prepregnancy body mass index < 18.5 kg/m(2). Methods This retrospective cohort study included 479 Japanese women with singleton pregnancies and a prepregnancy body mass index < 18.5 kg/m(2), who gave birth between 2013 and 2019 at Ohta Nishinouchi Hospital. The study included 22 (18 with preeclampsia and four with gestational hypertension) and 457 patients with and without hypertensive disorders of pregnancy, respectively. Results The prevalence of hypertensive disorders of pregnancy and preeclampsia was 4.6% and 3.8%, respectively. With weight gain during pregnancy (continuous variable) set as a reference, multiple logistic regression revealed that excessive weight gain during pregnancy increased the risk of preeclampsia (adjusted odds ratio: 1.13, 95% confidence interval: 1.00-1.28, p < 0.05) and hypertensive disorders of pregnancy (adjusted odds ratio: 1.15, 95% confidence interval: 1.03-1.29, p < 0.05). Based on receiver operating characteristic curve analyses (area under the curve 0.65, 95% confidence interval: 0.50-0.80; p < 0.05), we determined the cutoff value of weight gain during pregnancy for the occurrence of preeclampsia among women with body mass index < 18.5 kg/m(2) to be 13.0 kg, with sensitivity and specificity of 0.50 and 0.78, respectively. Conclusion This study indicates that excessive weight gain during pregnancy increases preeclampsia risk among underweight women and provides new recommendations for weight gain during pregnancy for such women. Further research regarding the pathogenesis of preeclampsia for underweight women is warranted.