Early-pregnancy weight gain and the risk of preeclampsia: A case-cohort study.
Early-pregnancy weight gain and the risk of preeclampsia: A case-cohort study.
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DOI：
10.1016/j.preghy.2018.10.005
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发表时间：
2018-10
期刊：
影响因子：
--
通讯作者：
Hutcheon JA
中科院分区：
文献类型：
--
作者：
Bodnar LM;Himes KP;Abrams B;Parisi SM;Hutcheon JA
研究妊娠早期体重增加与子痫前期风险之间的关系，为妊娠期体重增加建议提供依据。我们使用医院数据库进行了一项病例队列研究，其中包括宾夕法尼亚州匹兹堡Magee-Womens医院的80,812例单胎分娩（1998-2011年）。在6个孕前体重指数（BMI）组中，我们从多达339例子痫前期病例和1254例随机选择的孕妇的记录中提取了一系列产前体重测量数据。妊娠早期体重增加（妊娠16-19周）采用bmi特异性z评分图进行妊娠期标准化。采用多变量对数二项回归评估体重增加z评分与子痫前期风险之间的关系。我们使用概率偏倚分析确定子痫前期错误分类的影响。对于正常体重的女性，随着妊娠早期体重增加z评分的增加，子痫前期风险稳步增加。例如，与体重增加1.2 kg （z-score = - 1 SD）相比，16周体重增加7.2 kg （z-score = +1 SD）与每100次分娩1.3（0.50,2.2）例子痫前期病例相关。2级或3级肥胖妇女在16-19周体重减轻与子痫前期风险降低有关。在超重和1级肥胖妇女中无关联。偏倚分析支持常规分析的有效性。在某些BMI组中，妊娠早期体重增加可能与子痫前期有关。未来修订的孕期增重建议应考虑到本研究和其他研究带来的先兆子痫风险。
To investigate the association between early-pregnancy weight gain and risk of preeclampsia to inform pregnancy weight gain recommendations. We performed a case-cohort study using a hospital database including 80,812 singleton deliveries from Magee-Womens Hospital, Pittsburgh, Pennsylvania (1998-2011). In each of 6 prepregnancy body mass index (BMI) groups, we abstracted serial antenatal weight measurements from the records of up to 339 preeclampsia cases and 1254 randomly selected pregnancies. Early gestational weight gain (16-19 weeks’ gestation) was standardized for gestational duration using BMI-specific z-score charts. Multivariable log-binomial regression was used to assess the association between weight gain z-score and risk of preeclampsia. We determined the impact of preeclampsia misclassification using probabilistic bias analysis. Risk of preeclampsia For normal weight women, there was a steady increase in preeclampsia risk with increasing early gestational weight gain z-score. For example, compared with a weight gain of 1.2 kg (z-score = −1 SD), a 7.2-kg weight gain (z-score = +1 SD) at 16 weeks was associated with 1.3 (0.50, 2.2) excess preeclampsia cases per 100 deliveries. Weight loss at 16–19 weeks among grade 2 or 3 obese women was associated with a reduced risk of preeclampsia. Associations were null among overweight and grade 1 obese women. The bias analysis supported the validity of the conventional analysis. Early-pregnancy weight gain may be associated with preeclampsia in some BMI groups. Future revisions of pregnancy weight gain recommendations should account for preeclampsia risks from this and additional studies.
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DOI：
10.1111/j.1471-0528.2010.02593.x
发表时间：
2010-07-01
影响因子：
5.8
作者：
Mbah, A. K.;Kornosky, J. L.;Salihu, H. M.
通讯作者：
Salihu, H. M.
影响因子：
7.2
作者：
Localio, A. Russell;Margolis, David J.;Berlin, Jesse A.
通讯作者：
Berlin, Jesse A.
影响因子：
7.2
作者：
Cedergren, Marie I.
通讯作者：
Cedergren, Marie I.
影响因子：
7.1
作者：
Hutcheon, Jennifer A.;Platt, Robert W.;Bodnar, Lisa M.
通讯作者：
Bodnar, Lisa M.
影响因子：
7.2
作者：
Abuhamad, Alfred Z
通讯作者：
Abuhamad, Alfred Z