Differential effect of pre-pregnancy low BMI on fetal macrosomia: a population-based cohort study.
Differential effect of pre-pregnancy low BMI on fetal macrosomia: a population-based cohort study.
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孕前低体重指数对巨大胎儿的不同影响：一项基于人群的队列研究
DOI：
10.1186/s12916-021-02046-w
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发表时间：
2021-08-04
期刊：
影响因子：
9.3
通讯作者：
Xing Q
中科院分区：
文献类型：
--
作者：
Li G;Xing Y;Wang G;Zhang J;Wu Q;Ni W;Jiao N;Chen W;Liu Q;Gao L;Zhang Z;Wang Y;Xing Q
背景孕前低BMI对巨大儿的不同影响尚未完全阐明。在此，我们进行了一项全市范围内的人群为基础的队列研究，阐明孕前低BMI和巨大儿之间的关联，分层的母亲年龄，产次，GDM status.MethodsAll孕妇谁支付了他们的第一次产前检查在青岛的医院在2018年8月1日，2020年6月30日，被招募到这项研究。母亲年龄和孕前低BMI对巨大儿的交互作用进行了评估，使用Logistic回归模型，然后分层specific analysis.ResultsA共包括105,768对母子，巨大儿的比例为11.66%。母亲孕前BMI和年龄的交互作用对巨大儿的影响具有统计学意义，与产次无关（未产妇：P调整=0.0265;经产妇：P调整=0.0356）。低BMI对巨大儿的保护作用在35岁及以上的未产妇（aOR=0.16，95%CI 0.05-0.49）和25岁及以下的经产妇（aOR=0.17，95%CI 0.05-0.55）中最为显著。在无GDM的未产妇中，风险估计值随着受孕年龄的增加而逐渐下降（20-24岁：aOR=0.64，95% CI 0.51-0.80; 25-29岁：aOR=0.43，95% CI 0.36-0.52; 30-34岁：aOR=0.40，95% CI 0.29-0.53; ≥35岁：aOR=0.19，95% CI 0.06-0.60）。在患有GDM的未产妇中也可以观察到类似的模式，其中低BMI对巨大儿的aOR从25-29岁孕妇的0.54（95%CI 0.32-0.93）降至30-34岁孕妇的0.30（95%CI 0.12-0.75）。然而，年轻的经产母亲，特别是那些年龄在25岁及以下，没有GDM（aOR=0.21，95%CI 0.06-0.68），更受益于较低的BMI对巨大儿的发展。孕前低BMI对巨大儿的影响因母亲年龄和产次而异。较低的母亲BMI对巨大儿的保护作用在35岁及以上的初产妇中更为突出，而年龄小于25岁的经产妇则受益更多。
BackgroundThe differential effect of pre-pregnancy low BMI on macrosomia has not been fully addressed. Herein, we conducted a city-wide population-based cohort study to illuminate the association between pre-pregnancy low BMI and macrosomia, stratifying by maternal age, parity, and GDM status.MethodsAll pregnant women who paid their first prenatal visit to the hospital in Qingdao during August 1, 2018, to June 30, 2020, were recruited to this study. The interactive effect of maternal age and pre-pregnancy low BMI on macrosomia was evaluated using logistic regression models, followed by strata-specific analyses.ResultsA total of 105,768 mother-child pairs were included, and the proportion of fetal macrosomia was 11.66%. The interactive effect of maternal pre-pregnancy BMI and age was statistically significant on macrosomia irrespective of parity (nullipara:Padjusted=0.0265; multipara:Padjusted=0.0356). The protective effect of low BMI on macrosomia was most prominent among nullipara aged 35 years and above (aOR=0.16, 95% CI 0.05–0.49) and multipara aged 25 years and below (aOR=0.17, 95% CI 0.05–0.55). In nullipara without GDM, the risk estimates gradually declined with increasing conception age (20-to-24 years: aOR=0.64, 95% CI 0.51–0.80; 25-to-29 years: aOR=0.43 95% CI 0.36–0.52; 30-to-34 years: aOR=0.40 95% CI 0.29–0.53; and ≥35 years: aOR=0.19, 95% CI 0.06–0.60). A similar pattern could also be observed in nullipara with GDM, where the aOR for low BMI on macrosomia decreased from 0.54 (95% CI 0.32–0.93) in pregnant women aged 25–29 years to 0.30 (95% CI 0.12–0.75) among those aged 30–34 years. However, younger multiparous mothers, especially those aged 25 years and below without GDM (aOR=0.21, 95% CI 0.06–0.68), were more benefited from a lower BMI against the development of macrosomia.ConclusionsMaternal low BMI is inversely associated with macrosomia irrespective of maternal age and parity. The impact of pre-pregnancy low BMI on macrosomia varied by maternal age and parity. The protective effect of a lower maternal BMI against fetal macrosomia was more prominent in nulliparous mothers aged 35 years and above, whereas multiparous mothers younger than 25 years of age were more benefited.
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