Body mass index and gestational weight gain in migrant women by birth regions compared with Swedish-born women: A registry linkage study of 0.5 million pregnancies.
Body mass index and gestational weight gain in migrant women by birth regions compared with Swedish-born women: A registry linkage study of 0.5 million pregnancies.
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DOI：
10.1371/journal.pone.0241319
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Löf M
中科院分区：
文献类型：
--
作者：
Henriksson P;Sandborg J;Blomberg M;Nowicka P;Petersson K;Bendtsen M;Rosell M;Löf M
与本地出生的妇女相比，移徙到高收入国家的妇女发生不良妊娠结果的风险可能更高。然而，很少有人知道移民妇女是否更有可能有不健康的体重指数（BMI）或妊娠期体重增加（GWG），这是重要的，考虑到不健康的BMI和GWG与不良妊娠结局之间的既定联系。因此，本研究的目的是检查患病率和估计比值比（OR）的体重不足和肥胖的头三个月，以及出生地区的移民（第一代）和瑞典出生的妇女在人口为基础的样本在瑞典的孕妇GWG不足和过多。这项基于人群的研究包括2010年至2018年期间瑞典妊娠登记处的535，609例妊娠。该登记册的覆盖率约为90%，包括体重、身高、出生国和教育程度等数据。根据美国国家医学院的建议，怀孕前三个月的BMI被分类为体重不足、正常体重、超重和肥胖，而GWG被分类为不足、足够和过度。BMI和GWG按7个出生地区和100个出生国家进行检查。使用多项逻辑回归估计出生地区体重不足、肥胖以及GWG不足或过多的校正OR。出生地区之间不健康的BMI和GWG存在很大差异。例如，与出生在瑞典的女性相比，出生在北非、中东和撒哈拉以南非洲的女性肥胖几率分别高出1.40（95%CI 1.35-1.44）和2.13（95%CI 2.03-2.23）。然而，出生在撒哈拉以南非洲的女性体重不足（OR，2.93 [95% CI 2.70-3.18]）和GWG不足（OR，1.97 [95% CI 1.87-2.07]）的几率也要高得多。这项研究的局限性包括缺乏一个有效的文化适应措施，而且这项研究只有关于第一代移民的数据。7个区域和100个国家之间的巨大差异突出了考虑第一代移民妇女的出生区域和国家特定风险的重要性。此外，怀孕的第一代移民妇女，特别是在撒哈拉以南非洲出生的妇女中，GWG不足是常见的，这表明需要促进适当的GWG，而不仅仅是避免过度的GWG。因此，我们的研究结果还表明，可能需要为来自某些出生地区和国家的第一代移民妇女提供额外的支持和干预措施，以解决观察到的不健康BMI和GWG的差异。虽然还需要进一步的研究，但我们的研究结果对于确定怀孕期间不健康BMI和体重增加风险增加的女性群体是有用的。
Women migrating to high-income countries may have increased risks of adverse pregnancy outcomes as compared with native-born women. However, little is known whether migrant women are more likely to have unhealthy body mass index (BMI) or gestational weight gain (GWG), which is of importance considering the well-established links between unhealthy BMI and GWG with adverse pregnancy outcomes. Hence, the aim of the study was to examine the prevalence and estimate odds ratios (ORs) of underweight and obesity in the first trimester as well as inadequate and excessive GWG across birth regions in migrant (first-generation) and Swedish-born women in a population-based sample of pregnant women in Sweden. This population-based study included 535 609 pregnancies from the Swedish Pregnancy Register between the years 2010–2018. This register has a coverage of approximately 90% and includes data on body weight, height, birth country and educational attainment. BMI in the first trimester of pregnancy was classified as underweight, normal weight, overweight and obesity whereas GWG was classified as inadequate, adequate and excessive according to the recommendations from the National Academy of Medicine, USA. BMI and GWG were examined according to 7 birth regions and the 100 individual birth countries. Adjusted ORs of underweight, obesity as well as inadequate or excessive GWG by birth regions were estimated using multinomial logistic regression. There were large disparities in unhealthy BMI and GWG across birth regions. For instance, women born in North Africa and Middle East and Sub-Saharan Africa had 1.40 (95% CI 1.35–1.44) and 2.13 (95% CI 2.03–2.23) higher odds of obesity compared with women born in Sweden. However, women born in Sub-Saharan Africa had also considerably higher odds of underweight (OR, 2.93 [95% CI 2.70–3.18]) and inadequate GWG (OR, 1.97 [95% CI 1.87–2.07]). The limitations of the study include the lack of a validated measure of acculturation and that the study only had data on first-generation migration. The large differences across the 7 regions and 100 countries highlights the importance of considering birth region and country-specific risks of unhealthy BMI and GWG in first-generation migrant women. Furthermore, inadequate GWG was common among pregnant first-generation migrant women, especially in women born in Sub-Saharan Africa, which demonstrates the need to promote adequate GWG, not only the avoidance of excessive GWG. Thus, our findings also indicate that additional support and interventions may be needed for first-generation migrant women from certain birth regions and countries in order to tackle the observed disparities in unhealthy BMI and GWG. Although further studies are needed, our results are useful for identifying groups of women at increased risk of unhealthy BMI and weight gain during pregnancy.
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影响因子：
6.9
作者：
Gaillard, Romy;Durmus, Busra;Jaddoe, Vincent W. V.
通讯作者：
Jaddoe, Vincent W. V.
DOI：
10.1016/j.ejogrb.2015.06.031
发表时间：
2015-10
期刊：
European journal of obstetrics, gynecology, and reproductive biology
影响因子：
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作者：
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通讯作者：
Jaddoe VW
影响因子：
4.3
作者：
Stephansson, Olof;Petersson, Kerstin;Wikstrom, Anna-Karin
通讯作者：
Wikstrom, Anna-Karin
影响因子：
8.9
作者：
Liu, P.;Xu, L.;Wang, Z.
通讯作者：
Wang, Z.
DOI：
10.1016/s0140-6736(18)32114-7
发表时间：
2018-12-15
期刊：
Lancet (London, England)
影响因子：
--
作者：
Abubakar I;Aldridge RW;Devakumar D;Orcutt M;Burns R;Barreto ML;Dhavan P;Fouad FM;Groce N;Guo Y;Hargreaves S;Knipper M;Miranda JJ;Madise N;Kumar B;Mosca D;McGovern T;Rubenstein L;Sammonds P;Sawyer SM;Sheikh K;Tollman S;Spiegel P;Zimmerman C;UCL–Lancet Commission on Migration and Health
通讯作者：
UCL–Lancet Commission on Migration and Health