Pre-pregnancy weight and the risk of stillbirth and neonatal death
Pre-pregnancy weight and the risk of stillbirth and neonatal death
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DOI：
10.1111/j.1471-0528.2005.00437.x
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发表时间：
2005-04-01
影响因子：
5.8
通讯作者：
Secher, NJ
中科院分区：
文献类型：
--
作者：
Kristensen, J;Vestergaard, M;Secher, NJ
目的探讨孕妇孕前体重指数（BMI）与死产和新生儿死亡风险的关系，并研究其死亡原因。人口24，505单胎妊娠（112死产，75新生儿死亡）被纳入analysis.Methods信息的母亲孕前体重，身高，生活方式因素和产科危险因素，获得自填式问卷和医院档案。我们根据怀孕前BMI将人群分类为体重不足（BMI < 18.5 kg/m2），体重正常（BMI 18.5-24.9 kg/m（2）），超重（BMI 25-29.9 kg/m2）和肥胖（BMI 30.0 kg/m（2）或以上）主要观察指标死产和新生儿死亡及死亡原因。结果母亲肥胖与死产风险增加一倍以上有关（比值比= 2.8，95%置信区间[CI]：1.5-5.3）和新生儿死亡（比值比= 2.6，95% CI：1.2-5.8）。在体重不足或超重的妇女中，死产或新生儿死亡的风险没有统计学显著增加。对母亲吸烟、酒精和咖啡因摄入量、母亲年龄、身高、产次、孩子性别、受教育年限、工作状况和与伴侣同居的调整并没有改变结论，排除患有高血压疾病或糖尿病的女性也没有改变结论。没有单一的死亡原因解释了肥胖妇女的儿童死亡率较高，但更多的死产是由不明原因的宫内死亡和胎儿胎盘功能障碍肥胖妇女相比，正常体重women.Conclusion产妇肥胖一倍以上的死产和新生儿死亡的风险在我们的研究。目前和其他研究将孕产妇肥胖与严重不良妊娠结局风险增加联系起来，强调需要采取公共干预措施预防年轻女性肥胖。
Objective To evaluate the association between maternal pre-pregnancy body mass index (BMI) and the risk of stillbirth and neonatal death and to study the causes of death among the children.Design Cohort study of pregnant women receiving routine antenatal care in Aarhus, Denmark.Setting Aarhus University Hospital, Denmark, 1989-1996. Population A total of 24,505 singleton pregnancies (112 stillbirths, 75 neonatal deaths) were included in the analyses.Methods Information on maternal pre-pregnancy weight, height, lifestyle factors and obstetric risk factors were obtained from self-administered questionnaires and hospital files. We classified the population according to pre-pregnancy BMI as underweight (BMI < 18.5 kg/m(2)), normal weight (BMI 18.5-24.9 kg/m(2)), overweight (BMI 25-29.9 kg/m(2)) and obese (BMI 30.0 kg/m(2) or more).Main outcome measures Stillbirth and neonatal death and causes of death.Results Maternal obesity was associated with a more than doubled risk of stillbirth (odds ratio = 2.8, 95% confidence interval [CI]: 1.5-5.3) and neonatal death (odds ratio = 2.6, 95% CI: 1.2-5.8) compared with women of normal weight. No statistically significantly increased risk of stillbirth or neonatal death was found among underweight or overweight women. Adjustment for maternal cigarette smoking, alcohol and caffeine intake, maternal age, height, parity, gender of the child, years of schooling, working status and cohabitation with partner did not change the conclusions, nor did exclusion of women with hypertensive disorders or diabetes mellitus. No single cause of death explained the higher mortality in children of obese women, but more stillbirths were caused by unexplained intrauterine death and fetoplacental dysfunction among obese women compared with normal weight women.Conclusion Maternal obesity more than doubled the risk of stillbirth and neonatal death in our study. The present and other studies linking maternal obesity to an increased risk of severe adverse pregnancy outcomes emphasise the need for public interventions to prevent obesity in young women.