Super-obesity and risk for early and late pre-eclampsia
Super-obesity and risk for early and late pre-eclampsia
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DOI：
10.1111/j.1471-0528.2010.02593.x
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发表时间：
2010-07-01
影响因子：
5.8
通讯作者：
Salihu, H. M.
中科院分区：
文献类型：
--
作者：
Mbah, A. K.;Kornosky, J. L.;Salihu, H. M.
目的探讨肥胖亚型与早期和晚期先兆子痫风险之间的关系。设计基于人群的回顾性研究。设置密苏里州母系关联的出生队列文件。人口所有单胎活产在密苏里州从1989年至2005年。方法使用体重指数（BMI）将妇女归类为正常体重9 kg/m2）、I类肥胖（BMI = 30-34.9 kg/m2）、II类肥胖（BMI = 35-39.9 kg/m2）、III类肥胖（BMI = 40-49.9 kg/m2）或超级肥胖（BMI >= 50 kg/m2）。调整后的比值比（OR）和95%的置信区间（CI）肥胖和先兆子痫的风险之间的关联，从Logistic回归模型与调整intraclustercorrelation.ResultsThe先兆子痫的发病率随着BMI的增加而增加，与超肥胖的妇女有最高的发病率（13.4%）。与正常体重妇女相比，肥胖妇女（BMI ≥ 30 kg/m2）发生子痫前期的危险性更高（OR = 2.59，95% CI = 2.87-3.01）。晚发型先兆子痫（先兆子痫发生在妊娠34周或更长时间）的风险大致相同，而早发型先兆子痫（先兆子痫发生在妊娠34周或更短时间）的风险略有降低。在每个BMI类别中，先兆子痫的风险随着体重增加而增加。与体重正常但体重增加适中的母亲相比，体重增加速度快的超肥胖妇女发生先兆子痫的危险性最大（OR = 7.52，95%CI = 2.70-21.0）。结论体重指数和体重增加速度是超肥胖妇女先兆子痫的协同危险因素。
ObjectiveTo examine the association between obesity subtypes and risk of early and late pre-eclampsia.DesignPopulation-based retrospective study.SettingState of Missouri maternally linked birth cohort files.PopulationAll singleton live births in the state of Missouri from 1989 to 2005.MethodsThe body mass index (BMI) was used to classify women as normal weight (BMI = 18.5-24.9 kg/m2), class I obesity (BMI = 30-34.9 kg/m2), class II obesity (BMI = 35-39.9 kg/m2), class III obesity (BMI = 40-49.9 kg/m2) or super-obesity (BMI >= 50 kg/m2). Adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between obesity and the risk of pre-eclampsia were obtained from logistic regression models with adjustment for intracluster correlation.ResultsThe rate of pre-eclampsia increased with increasing BMI, with super-obese women having the highest incidence (13.4%). Compared with normal weight women, obese women (BMI >= 30 kg/m2) had a higher risk for pre-eclampsia (OR = 2.59, 95% CI = 2.87-3.01). This risk remained approximately the same for late-onset pre-eclampsia (pre-eclampsia occurring at 34 weeks or more of gestation) and was slightly reduced for early-onset pre-eclampsia (pre-eclampsia occurring at 34 weeks or less of gestation). Within each BMI category, the risk of pre-eclampsia increased with the rate of weight gain. Compared with normal weight mothers with moderate weight gain, super-obese women with a high rate of weight gain had the greatest risk for pre-eclampsia (OR = 7.52, 95% CI = 2.70-21.0).ConclusionBMI and rate of weight gain are synergistic risk factors that amplify the burden of pre-eclampsia among super-obese women.