Maternal obesity and neonatal mortality according to subtypes of preterm birth
Maternal obesity and neonatal mortality according to subtypes of preterm birth
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DOI：
10.1097/01.aog.0000286760.46679.f8
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发表时间：
2007-11-01
影响因子：
7.2
通讯作者：
Olsen, Jorn
中科院分区：
文献类型：
--
作者：
Nohr, Ellen A.;Vaeth, Michael;Olsen, Jorn
目的：为了研究孕前体重指数（BMI）和新生儿死亡率之间的关联，同时考虑到分娩的时间和亚型的早产birth.Methods：研究人群包括85,375活产单胎的母亲在丹麦国家出生队列（1996年至2002年）在第二个三个月期间接受采访。有关妊娠结局和新生儿死亡的信息（n=：230）从国家登记处获得。通过考克斯回归分析估计这种关联，结果以风险比和95%置信区间（Cls）表示。与怀孕前体重正常的母亲的婴儿相比，（BMI为18.5或以上但小于25），超重母亲所生婴儿的新生儿死亡率增加（BMI ≥ 25但<30）或肥胖（BMI ≥ 30）（校正风险比分别为1.7，CI 1.2-2.5和1.6，CI 1.0-2.4）。对于早产儿（n= 3，934，136例死亡），如果出生于超重或肥胖母亲，则早产胎膜早破（PROM）后出生的婴儿的新生儿死亡率显著增加（校正风险比3.5，CI 1.4-8.7和5.7，CI 2.2-14.8）。有没有关联高BMI和新生儿死亡率在自发性早产后出生的婴儿没有早产胎膜早破或在诱导早产delivery.Conclusion后出生的婴儿：高母亲体重似乎增加新生儿死亡的风险，特别是在早产胎膜早破后出生的婴儿。与肥胖相关的炎症或感染可能是因果途径的一部分。
Objective: To examine the association between prepregnancy body mass index (BMI) and neonatal mortality while accounting for the timing of delivery and subtypes of preterm birth.Methods: The study population included 85,375 live-born singletons of mothers in the Danish National Birth Cohort (1996-2002) who were interviewed during the second trimester. Information about pregnancy outcomes and neonatal deaths (n=:230) was obtained from national registers. The association was estimated by Cox regression analyses and results were presented as hazard ratios with 95% confidence intervals (Cls).Results: Compared with infants of mothers who were at a normal weight before pregnancy (BMI of 18.5 or more but less than 25), neonatal mortality was increased in infants of mothers who were overweight (BMI of 25 or more but less than 30) or obese (BMI of 30 or more) (adjusted hazard ratios 1.7, Cl 1.2-2.5, and 1.6, Cl 1.0-2.4, respectively). For preterm infants (n=3,934, 136 deaths), neonatal mortality in infants born after preterm premature rupture of membranes (PROM) was significantly increased if they were born to an overweight or obese mother (adjusted hazard ratios 3.5, CI 1.4-8.7, and 5.7, CI 2.2-14.8). There were no associations between high BMI and neonatal mortality in infants born after spontaneous preterm birth without preterm PROM or in infants born after induced preterm delivery.Conclusion: High maternal weight seems to increase the risk of neonatal mortality, especially in infants born after preterm PROM. Inflammation or infection related to obesity may be part of the causal pathway.