Primary Preeclampsia in the second pregnancy - Effects of changes in prepregnancy body mass index between pregnancies
Primary Preeclampsia in the second pregnancy - Effects of changes in prepregnancy body mass index between pregnancies
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DOI：
10.1097/01.aog.0000292090.40351.30
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发表时间：
2007-12-01
影响因子：
7.2
通讯作者：
Smulian, John C.
中科院分区：
文献类型：
--
作者：
Getahun, Darios;Ananth, Cande V.;Smulian, John C.
目的：为了研究妇女前两次妊娠的孕前体重指数（BMI）变化与第二次妊娠先兆子痫发病率之间的关系，我们对密苏里州（1989 - 1997）妇女前两次单胎妊娠（n= 136，884）的数据进行了以人群为基础的回顾性队列分析。该研究仅限于首次怀孕时没有先兆子痫的妇女。孕前BMI（kg/m2）分为体重不足（小于18.5）、正常（18.5-24.9）、超重（25-29.9）和肥胖（30或更高）。结果：第二次妊娠先兆子痫的发生率为2.0%。与两次怀孕BMI均正常的妇女相比，当前两次怀孕BMI从体重不足变为肥胖时，先兆子痫的风险增加（比值比[OR] 5.6，95%置信区间[Cl] 1.7-18.2），正常至超重（OR 2.0，95% CI 1.7-2.3）、正常至肥胖（OR 3.2，95% CI 2.5-4.2）和超重至肥胖（OR 3.7，95% CI 3.1-4.3）。在两次怀孕中肥胖或超重与第二次怀孕中先兆子痫的风险增加有关。在两次怀孕之间将BMI从体重不足增加到正常或超重的妇女，其先兆子痫的风险与两次怀孕中BMI正常的妇女相当。非裔美国人，但不是白色，妇女谁减少了BMI从肥胖或超重到正常之间怀孕仍然在增加先兆子痫的风险。结论：增加孕前BMI从正常体重超重或肥胖之间怀孕与先兆子痫的风险增加，在随后的怀孕。
OBJECTIVE: To examine the association between changes in prepregnancy body mass index (BMI) between a woman's first two pregnancies and incidence of preeclampsia in the second pregnancy.METHODS: We performed a population-based retrospective cohort analysis using data on women's first two singleton pregnancies (n=136,884) in Missouri (19891997). The study was restricted to women without preeclampsia in the first pregnancy. Prepregnancy BMI (kg/m(2)) was categorized as underweight (less than 18.5), normal (18.5-24.9), overweight (25-29.9), and obese (30 or greater). Analyses were adjusted for confounders through multivariable logistic regression.RESULTS: The incidence rate of preeclampsia in the second pregnancy was 2.0%. In comparison with women who were of normal BMI in both pregnancies, the risk for preeclampsia increased when BMI changed between the first two pregnancies from underweight to obese (odds ratio [OR] 5.6, 95% confidence interval [Cl] 1.7-18.2), normal to overweight (OR 2.0, 95% Cl 1.7-2.3), normal to obese (OR 3.2, 95% Cl 2.5-4.2), and overweight to obese (OR 3.7, 95% Cl 3.1-4.3). Being obese or overweight in both pregnancies was associated with increased risk of preeclampsia in the second pregnancy. Women who increased their BMI from underweight to normal or overweight between pregnancies had risks of preeclampsia comparable with those with normal BMI in both pregnancies. African-American, but not white, women who had a reduction in BMI from obese or overweight to normal between pregnancies remained at increased risk for preeclampsia.CONCLUSION: Increases in prepregnancy BMI from normal weight to overweight or obese between pregnancies are associated with increased risk of preeclampsia in the subsequent pregnancy.