Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and meta-analyses
Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and meta-analyses
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DOI：
10.1093/ije/dyq195
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发表时间：
2011-02-01
影响因子：
7.7
通讯作者：
McDonald, Sarah D.
中科院分区：
文献类型：
--
作者：
Han, Zhen;Mulla, Sohail;McDonald, Sarah D.
背景尽管目前肥胖流行，产妇体重不足仍然是一个常见的发生与潜在的不良围产期结果。我们的目的是确定产妇体重不足和早产（PTB）和低出生体重（LBW）在单胎妊娠在发展中国家和发达countries.Methods之间的关系，我们遵循MOOSE共识声明。检索MEDLINE和EMBASE。我们纳入的研究评估了单胎妊娠中母亲体重不足与体重正常相比对我们两个主要结局的影响：PTB（< 37周）和LBW（<2500 g）。两名评估员独立审查引文，提取数据和评估quality.Results共纳入78篇研究，涉及1 025 794名妇女。在体重不足女性的队列研究中，PTB的总体风险增加[校正的相对风险（RR）1.29，95%置信区间（CI）1.15-1.46]，自发性PTB（校正的RR 1.32，95% CI 1.10-1.57）和诱导性PTB（校正的RR 1.21，95% CI 1.07-1.36）的风险也是如此。体重过轻的妇女出生低出生体重儿的风险增加（调整后的RR 1.64，95% CI 1.38-1.94）。在发达国家，体重不足的妇女患肺结核的风险增加（RR 1.22，95% CI 1.15-1.30），但在发展中国家则不然（RR 0.99，95% CI 0.67-1.45）。在发达国家和发展中国家，体重不足的妇女生低出生体重婴儿的风险增加（RR 1.48，95%CI 1.29-1.68和RR 1.52，95%CI 1.25-1.85）。结论在本系统回顾和荟萃分析中，我们确定体重不足妇女的单胎婴儿具有较高的PTB风险（总体，自发和诱导）和LBW比那些出生的妇女与正常体重。
Background Despite the current obesity epidemic, maternal underweight remains a common occurrence with potential adverse perinatal outcomes. Our objective was to determine the relationship between maternal underweight and preterm birth (PTB) and low birth weight (LBW) in singleton pregnancies in developing and developed countries.Methods We followed the MOOSE consensus statement. We searched MEDLINE and EMBASE from their inceptions. We included studies that assessed the effect of maternal underweight compared with normal weight according to body mass index in singleton gestations on our two primary outcomes: PTB (< 37 weeks) and LBW (< 2500g). Two assessors independently reviewed citations, extracted data and assessed quality.Results A total of 78 studies were included involving 1 025 794 women. The overall risk of PTB was increased in the cohort studies of underweight women [adjusted relative risk (RR) 1.29, 95% confidence interval (CI) 1.15-1.46], as were the risks of spontaneous PTB (adjusted RR 1.32, 95% CI 1.10-1.57) and induced PTB (adjusted RR 1.21, 95% CI 1.07-1.36). Underweight women had an increased risk of an LBW infant (adjusted RR 1.64, 95% CI 1.38-1.94). In developed countries, underweight women had an increased risk of PTB (RR 1.22, 95% CI 1.15-1.30) but not in developing countries (RR 0.99, 95% CI 0.67-1.45). In both developed and developing countries, underweight women were at increased risk of having an LBW infant (RR 1.48, 95% CI 1.29-1.68, and RR 1.52, 95% CI 1.25-1.85, respectively).Conclusions In this systematic review and meta-analyses, we determined that singletons born to underweight women have higher risks of PTB (overall, spontaneous and induced) and LBW than those born to women with normal weight.