Association of maternal pre-pregnancy low or increased body mass index with adverse pregnancy outcomes.
Association of maternal pre-pregnancy low or increased body mass index with adverse pregnancy outcomes.
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DOI：
10.1038/s41598-021-82064-z
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发表时间：
2021-02-15
影响因子：
4.6
通讯作者：
Zhao Q
中科院分区：
文献类型：
--
作者：
Tang J;Zhu X;Chen Y;Huang D;Tiemeier H;Chen R;Bao W;Zhao Q
本研究调查了中国广东省参加全国免费孕前健康检查项目的妇女孕前体重指数（BMI）与不良妊娠结局的关系，并根据母亲年龄探讨了这些关系。根据中国标准将孕前BMI分为低体重（BMI < 18.5 kg/m2）、健康体重（18.5-23.9 kg/m2）、超重（24.0-27.9 kg/m2）和肥胖（≥ 28.0 kg/m2）。结局为早产（PTB，妊娠37周前分娩）、大于胎龄儿（LGA，出生体重高于胎龄儿性别的第90百分位数）、小于胎龄儿（SGA，出生体重低于胎龄儿性别的第10百分位数）、初次剖腹产、肩难产或产伤和死产。分别计算体重不足、超重和肥胖的校正发病风险比（aIRR）。与健康体重相比，体重不足与PTB（aIRR 1.06，95%CI 1.04-1.09）和SGA（1.23，1.22-1.26）的风险增加相关，但与LGA（0.83，0.82-0.85）、初次剖腹产（0.88，0.87-0.90）和死产（0.73，0.53-0.99）呈负相关。超重与LGA（1.17，1.14-1.19）、初次剖腹产（1.18，1.16-1.20）和死产（1.44，1.03-2.06）的风险增加相关，但与SGA（0.92，0.90-0.95）和肩难产或产伤（0.86，0.79-0.93）呈负相关。肥胖与PTB（1.12，1.05-1.20），LGA（1.32，1.27-1.37），初次剖腹产（1.45，1.40-1.50）的风险增加相关，但与SGA（0.92，0.87-0.97）呈负相关。根据母亲年龄，体重不足、超重和肥胖与这些不良妊娠结局相关的aIRR范围为0.65至1.52。在中国人群中，母亲孕前BMI与不良妊娠结局的风险显著相关，且风险因母亲年龄而异。进一步的调查是必要的，以确定是否以及如何咨询和干预的妇女与低或增加体重指数怀孕前可以减少不良妊娠结局的风险。
This study investigated the association between pre-pregnancy body mass index (BMI) and adverse pregnancy outcomes among women participated in the National Free Preconception Health Examination Project in Guangdong Province, China, and explored these associations according to maternal age. Pre-pregnancy BMI was classified into underweight (BMI < 18.5 kg/m2), healthy weight (18.5–23.9 kg/m2), overweight (24.0–27.9 kg/m2), and obesity (≥ 28.0 kg/m2) according to Chinese criteria. Outcomes were preterm birth (PTB, delivery before 37 weeks of gestation), large for gestational age (LGA, birthweight above the 90th percentile for gestational age by infants’ sex), small for gestational age (SGA, birthweight below the 10th percentile for gestational age by infants’ sex), primary caesarean delivery, shoulder dystocia or birth injury, and stillbirth. Adjusted incidence risk ratios (aIRR) were calculated for underweight, overweight and obesity, respectively. Compared with healthy weight, underweight was associated with increased risk of PTB (aIRR 1.06, 95%CI 1.04–1.09) and SGA (1.23, 1.22–1.26) but inversely associated with LGA (0.83, 0.82–0.85), primary caesarean delivery (0.88, 0.87–0.90) and stillbirth (0.73, 0.53–0.99). Overweight was associated with increased risk of LGA (1.17, 1.14–1.19), primary caesarean delivery (1.18, 1.16–1.20) and stillbirth (1.44, 1.03–2.06), but inversely associated with SGA (0.92, 0.90–0.95) and shoulder dystocia or birth injury (0.86, 0.79–0.93). Obesity was associated with increased risk of PTB (1.12, 1.05–1.20), LGA (1.32, 1.27–1.37), primary caesarean delivery (1.45, 1.40–1.50), but inversely associated with SGA (0.92, 0.87–0.97). The aIRRs for underweight, overweight and obesity in relation to these adverse pregnancy outcomes ranged from 0.65 to 1.52 according to maternal age. In Chinese population, maternal pre-pregnancy BMI was significantly associated with the risk of adverse pregnancy outcomes and the risk differs according to maternal age. Further investigation is warranted to determine whether and how counselling and interventions for women with low or increased BMI before pregnancy can reduce the risk of adverse pregnancy outcomes.
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影响因子：
4.5
作者：
Bhattacharya S;Campbell DM;Liston WA;Bhattacharya S
通讯作者：
Bhattacharya S
1996 - 2015年中国国家和地区全因原因和特定儿童死亡率：系统分析，对可持续发展目标有影响。
DOI：
10.1016/s2214-109x(16)30334-5
发表时间：
2017-02
期刊：
The Lancet. Global health
影响因子：
--
作者：
He C;Liu L;Chu Y;Perin J;Dai L;Li X;Miao L;Kang L;Li Q;Scherpbier R;Guo S;Rudan I;Song P;Chan KY;Guo Y;Black RE;Wang Y;Zhu J
通讯作者：
Zhu J
影响因子：
8.9
作者：
Liu, P.;Xu, L.;Wang, Z.
通讯作者：
Wang, Z.
影响因子：
4.9
作者：
Ram, Maya;Berger, Howard;Melamed, Nir
通讯作者：
Melamed, Nir
影响因子：
3.8
作者：
Rosen, Hadar;Shmueli, Anat;Aviram, Amir
通讯作者：
Aviram, Amir