Pre-pregnancy body mass index and weight gain during pregnancy in relation to preterm delivery subtypes
Pre-pregnancy body mass index and weight gain during pregnancy in relation to preterm delivery subtypes
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DOI：
10.1080/00016340801996838
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发表时间：
2008-01-01
影响因子：
4.3
通讯作者：
Williams, Michelle A.
中科院分区：
文献类型：
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作者：
Rudra, Carole B.;Frederick, Ihunnaya O.;Williams, Michelle A.
背景。早产 (PTD) 与孕前体重指数 (BMI) 和妊娠体重增加之间的关联可能因结果亚型而异。方法。作者分析了美国华盛顿州西部 2,468 名队列参与者（1996-2005 年）的数据，并检查了孕前 BMI 和从孕前到妊娠 18-22 周的体重增加率与早产后自发性 PTD、早产胎膜早破 (PPROM) 后自发性 PTD 以及指示性 PTD 的关系。结果。 BMI 每增加 5kg/m(2) 与指定的 PTD 相关（调整后的比值比 [OR] 1.71，95% 置信区间 [CI] 1.40-2.06）。在对怀孕前和/或怀孕期间的高血压和糖尿病进行调整后，这种关联有所减弱（5kg/m(2)调整后的OR，1.40；95% CI，1.12-1.75）。与自发性 PTD 和 PPROM 的关联较弱（5kg/m2 调整后的 OR 分别为 0.90 和 1.14）。在BMI正常的女性中，体重增加与预产期相关（调整后OR，1.22；95% CI，1.02-1.45），但在超重或肥胖女性中则不然（调整后OR，1.02；95% CI，0.87-1.20）。体重增加与自发 PTD 呈负相关（0.1kg/周调整后 OR，0.87；95% CI，0.77-0.99），与 PPROM 没有很强的相关性（调整后 OR，1.03；95% CI，0.90-1.17）。结论。孕前超重增加表明 PTD 风险与高血压和糖尿病无关。妊娠早期体重增加较多表明体重指数正常的女性存在 PTD 风险。
Background. Associations between preterm delivery (PTD) and pre-pregnancy body mass index (BMI) and pregnancy weight gain may differ across outcome subtypes. Methods. The authors analyzed data from 2,468 cohort participants in western Washington State, USA (1996-2005) and examined pre-pregnancy BMI and weight gain rate from pre-pregnancy to 18-22 weeks' gestation in relation to spontaneous PTD after preterm labor, spontaneous PTD after preterm premature rupture of membranes (PPROM), and indicated PTD. Results. Each 5kg/m(2) BMI increase was associated with indicated PTD (adjusted odds ratio [OR] 1.71, 95% confidence interval [CI] 1.40-2.06). The association weakened somewhat after adjustment for hypertension and diabetes before and/or during pregnancy (5kg/m(2) adjusted OR, 1.40; 95% CI, 1.12-1.75). Associations with spontaneous PTD and PPROM were weaker (5kg/m2 adjusted ORs, 0.90 and 1.14, respectively). Weight gain was associated with indicated delivery among women with normal BMI (0.1kg/week adjusted OR, 1.22; 95% CI, 1.02-1.45) but not among overweight or obese women (adjusted OR, 1.02; 95% CI, 0.87-1.20). Weight gain was inversely associated with spontaneous PTD (0.1kg/week adjusted OR, 0.87; 95% CI, 0.77-0.99) and not strongly associated with PPROM (adjusted OR, 1.03; 95% CI, 0.90-1.17). Conclusions. Pre-pregnancy overweight increases indicated PTD risk independently of hypertension and diabetes. High early pregnancy weight gain increases indicated PTD risk in women with a normal BMI.