Cedergren Marie I, Källén Bengt A J
Division of Obstetrics and Gynaecology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Obes Res. 2003 Sep;11(9):1065-71. doi: 10.1038/oby.2003.146.
This study determined whether obese women have an increased risk of cardiovascular defects in their offspring compared with average weight women.
In a case-control study, prospectively collected information was obtained from Swedish medical health registers. The study included 6,801 women who had infants with a cardiovascular defect and, as controls, all delivered women (N = 812,457) during the study period (1992 to 2001). Infants with chromosomal anomalies or whose mothers had pre-existing diabetes were excluded. Obesity was defined as BMI >29 kg/m(2), and morbid obesity was defined as BMI >35 kg/m(2). Comparisons were made with average weight women (BMI = 19.8 to 26 kg/m(2)).
In the group of obese mothers, there was an increased risk for cardiovascular defects compared with the average weight mothers [adjusted odds ratio (OR) = 1.18; 95% CI, 1.09 to 1.27], which was slightly more pronounced for the severe types of cardiovascular defects (adjusted OR = 1.23; 95% CI, 1.05 to 1.44). With morbid obesity, the OR for cardiovascular defects was 1.40 (95% CI, 1.22 to 1.64), and for severe cardiovascular defects, the OR was 1.69 (95% CI, 1.27 to 2.26). There was an increased risk for all specific defects studied among the obese women, but only ventricular septal defects and atrial septal defects reached statistical significance.
In this sample, a positive association was found between maternal obesity in early pregnancy and congenital heart defects in the offspring. A suggested explanation is undetected type 2 diabetes in early pregnancy, but other explanations may exist.
本研究旨在确定与体重正常的女性相比，肥胖女性的后代患心血管缺陷的风险是否增加。
在一项病例对照研究中，前瞻性收集了来自瑞典医疗卫生登记处的信息。该研究纳入了6801名生育患有心血管缺陷婴儿的女性，并以研究期间（1992年至2001年）所有分娩的女性（N = 812457）作为对照。排除患有染色体异常或母亲患有孕前糖尿病的婴儿。肥胖定义为体重指数（BMI）>29 kg/m²，病态肥胖定义为BMI>35 kg/m²。与体重正常的女性（BMI = 19.8至26 kg/m²）进行比较。
与体重正常的母亲相比，肥胖母亲组的后代患心血管缺陷的风险增加[调整后的优势比（OR）= 1.18；95%置信区间（CI），1.09至1.27]，这在严重类型的心血管缺陷中更为明显（调整后的OR = 1.23；95% CI，1.05至1.44）。对于病态肥胖，心血管缺陷的OR为1.40（95% CI，1.22至1.64），对于严重心血管缺陷，OR为1.69（95% CI，1.27至2.26）。肥胖女性中研究的所有特定缺陷的风险均增加，但只有室间隔缺损和房间隔缺损达到统计学意义。
在该样本中，发现孕早期母亲肥胖与后代先天性心脏缺陷之间存在正相关。一种可能的解释是孕早期未被检测出的2型糖尿病，但也可能存在其他解释。
