Association Between Preterm Delivery and Pre-pregnancy Body Mass (BMI), Exercise and Sleep During Pregnancy Among Working Women in Southern California
Association Between Preterm Delivery and Pre-pregnancy Body Mass (BMI), Exercise and Sleep During Pregnancy Among Working Women in Southern California
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DOI：
10.1007/s10995-012-1052-5
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发表时间：
2013-05-01
影响因子：
2.3
通讯作者：
Kharrazi, Martin
中科院分区：
文献类型：
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作者：
Guendelman, Sylvia;Pearl, Michelle;Kharrazi, Martin
除了戒烟之外，人们对可改变生活方式的因素知之甚少，这些因素可以预防早产（PTD，< 37周妊娠）。我们研究了孕前BMI、孕中期运动和睡眠对PTD的个体和联合关联。我们进行了一项巢式、基于人群的病例对照研究，访问了344例产后分娩< 37周的病例，这些病例通过产前筛查记录中的临床估计胎龄来确定，以及698例足月对照，不包括足月低出生体重。符合条件的妇女参加了加州全州范围的产前筛查计划，在怀孕期间工作，并于2002-2003年在南加州分娩了一个单胞胎。单独建模，适度（比值比[OR] = 0.90; 95%置信区间[CI] = 0.84-0.96-每小时/周）和剧烈运动（OR = 0.67; 95%CI = 0.46-0.98（是vs.否），在孕中期进行锻炼与PTD发生率降低相关，而睡眠时间与PTD发生率无关。（对于< 7 h，OR = 1.09，95%CI = 0.80-1.48;对于> 8 h，OR = 0.88，95%CI = 0.57-1.48对比7-8 h）。当睡眠和运动变量与孕前BMI一起沿着建模时，只有适度运动（OR = 0.91; 95% CI 0.85-0.98）继续与PTD几率降低相关。适度运动的益处在BMI大于24 kg/m2的女性中最强（OR = 0.85; 95% CI = 0.79-0.93），并随着BMI的降低而减弱。没有发现其他的相互作用。适度的运动与PTD的减少有关，特别是对于BMI高于正常范围的女性。这些结果与公共卫生相关，因为这些风险因素在怀孕前和怀孕期间都是潜在的可改变的，并且美国PTD的发病率仍然很高。
Little is known about modifiable lifestyle factors beyond quitting smoking that could prevent preterm delivery (PTD, < 37 weeks gestation). We examined the individual and joint associations of pre-pregnancy BMI, second trimester exercise and sleep on PTD. We conducted a nested, population-based case-control study interviewing postpartum 344 cases delivering at < 37 weeks, as identified by clinical estimate of gestational age from prenatal screening records, and 698 term controls, excluding term low birthweight. Eligible women participated in California's statewide Prenatal Screening Program, worked during pregnancy, and delivered a singleton birth in Southern California in 2002-2003. Modeled separately, moderate (odds ratio [OR] = 0.90; 95 % confidence interval [CI] = 0.84-0.96-per hour/week) and vigorous (OR = 0.67; 95 % CI = 0.46-0.98 for yes vs. no) exercise during the second trimester were associated with a reduced odds of PTD, and sleep duration was not (OR = 1.09, 95 % CI = 0.80-1.48 for < 7 h; OR = 0.88, 95 % CI = 0.57-1.48 for > 8 h vs. 7-8 h). When sleep and exercise variables were modeled together along with pre-pregnancy BMI, only moderate exercise (OR = 0.91; 95 % CI 0.85-0.98) continued to be associated with reduced odds of PTD. The benefits of moderate exercise appeared strongest for women with BMI greater than 24 kg/m(2) (OR = 0.85; 95 % CI = 0.79-0.93) and weakened with decreasing BMI. No other interactions were found. Moderate exercise is associated with reduced PTD, particularly for women with BMI above the normal range. The results are of public health relevance given that these risk factors are potentially modifiable both pre-conceptionally and during pregnancy and rates of PTD are still high in the United States.