Effect of Birth Weight and Early Pregnancy BMI on Risk for Pregnancy Complications
Effect of Birth Weight and Early Pregnancy BMI on Risk for Pregnancy Complications
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DOI：
10.1002/oby.22375
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发表时间：
2019-02-01
期刊：
影响因子：
6.9
通讯作者：
Roberts, Claire T.
中科院分区：
文献类型：
--
作者：
Andraweera, Prabha H.;Dekker, Gus;Roberts, Claire T.
目的探讨出生体重对妊娠期并发症的影响，包括先兆子痫（PE）、妊娠期高血压（GH）、小于胎龄儿（SGA）妊娠、自发性早产和妊娠期糖尿病（GDM），并评估孕早期BMI对这种关系的影响。方法纳入5,336例妊娠终点筛查（SCOPE）研究的初产妇。妇女的出生体重是自我报告的，并在可能的情况下通过医疗记录确认。3，000至3，499克的出生体重被视为参考。结果校正混杂因素后，出生体重< 2,500 g与GH风险增加相关（校正比值比[aOR] = 2.2，95% CI = 1.3-3.7），PE（aOR = 1.7，95% CI = 1.0-2.9）、小于胎龄儿（aOR = 1.9，95% CI = 1.1-3.2）和GDM（aOR = 2.4，95% CI = 1.0-5.8）。出生体重<2，500 g且随后超重或被诊断为肥胖的女性患GH的风险增加（aOR = 2.2，95% CI = 1.1-4.5），PE（aOR = 2.3，95%CI = 1.2-4.5）和GDM（aOR = 3.2，95%CI = 1.1-9.5）与出生体重>= 2，500 g且保持偏瘦的女性相比。结论低出生体重的妇女发生妊娠并发症的风险增加。那些出生时很小的人可能经历了“编程”，以应对不利的子宫内条件。对于这些女性来说，怀孕的生理需求可能会成为“第二次打击”，导致怀孕并发症。
Objective This study investigated the influence of birth weight on the risk of pregnancy complications, including preeclampsia (PE), gestational hypertension (GH), small for gestational age (SGA) pregnancy, spontaneous preterm birth, and gestational diabetes mellitus (GDM), and assessed the effect of early pregnancy BMI on this relationship. Methods A total of 5,336 nulliparous women from the SCreening fOr Pregnancy Endpoints (SCOPE) study were included. Women's birth weights were self-reported and confirmed via medical records when possible. A birth weight of 3,000 to 3,499 g was considered the reference. Results After adjusting for confounders, birth weight < 2,500 g was associated with increased risk of GH (adjusted odds ratio [aOR] = 2.2, 95% CI = 1.3-3.7), PE (aOR = 1.7, 95% CI = 1.0-2.9), small for gestational age (aOR = 1.9, 95% CI = 1.1-3.2), and GDM (aOR = 2.4, 95% CI = 1.0-5.8) compared with the referent. Women born with birth weight < 2,500 g and who subsequently developed overweight or were diagnosed with obesity were at increased risk of GH (aOR = 2.2, 95% CI = 1.1-4.5), PE (aOR = 2.3, 95% CI = 1.2-4.5), and GDM (aOR = 3.2, 95% CI = 1.1-9.5) compared with women with birth weight >= 2,500 g and remained lean. Conclusions Women who were born with a low birth weight are at increased risk of pregnancy complications. Those born small may have undergone "programming" in response to unfavorable intrauterine conditions. In such women, the physiological demands of pregnancy may act as a "second hit," leading to pregnancy complications.