文章摘要
张治萍,储莉鸣,褚水莲,陆梅,沈丽华,陈科,顾丽芳,吴海湉,沈洁.孕前超重、孕期过度增重与巨大儿发生风险的前瞻性队列研究[J].中华流行病学杂志,2018,39(8):1082-1085
孕前超重、孕期过度增重与巨大儿发生风险的前瞻性队列研究
Prospective cohort study on the risks of pre-pregnancy overweight, excessive gestational weight gain on macrosomia
投稿时间:2018-03-05  
DOI:10.3760/cma.j.issn.0254-6450.2018.08.013
中文关键词: 孕前超重;孕前肥胖;孕期过度增重;巨大儿;前瞻性队列研究
英文关键词: Prepregnancy overweight;Prepregnancy obesity;Excessive gestational weight gain;Macrosomia;Prospective cohort study
基金项目:浦东新区科技发展基金(PKJ2016-Y48)
作者单位E-mail
张治萍 201206 上海市浦东新区妇幼保健院妇产科  
储莉鸣 201206 上海市浦东新区妇幼保健院妇产科  
褚水莲 201206 上海市浦东新区妇幼保健院妇产科  
陆梅 200032 上海, 复旦大学生殖与发育研究院, 上海市计划生育科学研究所 国家卫生和计划生育委员会计划生育药具重点实验室  
沈丽华 201206 上海市浦东新区妇幼保健院妇产科  
陈科 200032 上海, 复旦大学生殖与发育研究院, 上海市计划生育科学研究所 国家卫生和计划生育委员会计划生育药具重点实验室  
顾丽芳 201206 上海市浦东新区妇幼保健院妇产科  
吴海湉 201206 上海市浦东新区妇幼保健院妇产科  
沈洁 200032 上海, 复旦大学生殖与发育研究院, 上海市计划生育科学研究所 国家卫生和计划生育委员会计划生育药具重点实验室 janny_shen@163.com 
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中文摘要:
      目的 探讨巨大儿发生与孕前超重、孕期过度增重的直接关联及关联强度。方法 2015年1月起在上海市浦东新区妇幼保健院建立孕妇队列,创建孕妇健康档案,收集孕期及分娩信息,包括一般人口学特征、孕前体重、孕期增重、分娩体重、孕期健康状况及各种孕期并发症、分娩情况等,计算孕前BMI及孕期增重,收集新生儿出生体重,了解巨大儿发生与孕前超重、孕期过度增重之间的关系。结果 巨大儿发生率为6.6%(149/2 243)。不同孕前BMI组巨大儿发生率差异有统计学意义(P=0.001)。在控制了孕妇年龄、孕产史等因素后,logistic回归分析结果显示,与孕前BMI适宜的孕妇比,孕前BMI超重以及肥胖的孕妇生产巨大儿的风险均增加(OR=3.12,95%CI:1.35~7.22,P=0.008; OR=2.99,95%CI:1.17~7.63,P=0.022)。不同孕期增重组巨大儿发生率差异有统计学意义(P=0.002)。在控制了孕妇年龄、孕产史、孕期并发症等因素后,logistic回归分析结果显示,与孕期增重适宜的孕妇比,孕期增重不足的孕妇生产巨大儿的风险降低(OR=0.52,95%CI:0.30~0.90,P=0.019)。而孕期过度增重在调整了各种孕期指标后,与孕期增重适宜的孕妇比,巨大儿发生风险差异有统计学意义(OR=1.41,95%CI:0.96~2.09,P=0.084)。结论 孕前超重或肥胖是巨大儿发生的风险因素。
英文摘要:
      Objective To investigate the risks of pre-pregnancy overweight, excessive gestational weight gain on macrosomia. Methods We conducted one hospital-based cohort study, focusing on pregnant women from January 2015. All pregnant women attending to this hospital for maternal check-ups, were included in our cohort and followed to the time of delivery. Data related to general demographic characteristics, pregnancy and health status of those pregnant women, was collected and maternal pre-pregnant BMI and maternal weight gain were calculated. Logistic regression was used to explore the risk difference of pre-pregnancy BMI, excessive gestational weight gain on macrosomia. Results The overall incidence of macrosomia in our cohort appeared as 6.6% (149/2 243). After adjusting the confounding factors including age and histories on pregnancy, pre-pregnancy overweight/obesity was associated with higher risks of macrosomia (OR=3.12, 95%CI:1.35-7.22, P=0.008; OR=2.99, 95%CI:1.17-7.63, P=0.022) when comparing to those with normal pre-pregnancy weight. Cesarean delivery and sex of the offspring were associated with higher risk of macrosomia, while excessive gestational weight gain showed no significant difference (OR=1.41, 95%CI:0.96-2.09, P=0.084). Our data showed that Macrosomia was statistically associated with gestational weight gain (P=0.002). After controlling parameters as age, history of pregnancy and related complications of the pregnant women, results from the logistic regression showed that women with gestational inadequate weight gain having reduced risks to deliver macrosomia, when compared to those pregnant women with adequate weight gain (OR=0.52, 95%CI:0.30-0.90, P=0.019). Conclusion Pre-pregnancy overweight and obesity were on higher risks to macrosomia.
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