Cheng Christine J, Bommarito Kerry, Noguchi Akihiko, Holcomb William, Leet Terry
Department of Community Health, Saint Louis University School of Public Health, St. Louis, Missouri, USA. chengc@
Obstet Gynecol. 2004 Aug;104(2):286-92. doi: 10.1097/01.AOG.0000134526.37657.b0.
To estimate whether maternal weight changes between pregnancies influence the risk for small for gestational age (SGA) births.
SGA cases (n = 8,062) below the tenth percentile birth weight for gestational age were selected from liveborn singletons born of Missouri residents during 1989-1997. Normal weight controls (n = 8,062) were selected according to birth year. The risk of SGA from interpregnancy body mass index (BMI) change and other maternal factors was estimated using logistic regression analysis.
An increase in BMI between pregnancies decreased SGA risk (adjusted odds ratio = 0.8; 95% confidence interval 0.7, 1.0). Other risk factors were prior SGA (4.4; 4.0, 4.8), preeclampsia/eclampsia (2.6; 2.1, 3.2), maternal cardiac disease (1.8; 1.1, 2.9), inadequate weight gain (1.9; 1.8, 2.2), and cigarette smoking (1.9; 1.7, 2.3 for 1-9 cigarettes per day; 2.5; 2.2, 2.8 for 10-19/d; and 2.8; 2.5, 3.3 for 20/d or more).
Increase in interpregnancy BMI lowers SGA risk, but adequate weight gain during pregnancy is more effective.
评估孕期之间孕妇体重变化是否会影响小于胎龄儿(SGA)出生风险。
从1989 - 1997年密苏里州居民出生的单胎活产儿中选取出生体重低于胎龄第十百分位数的SGA病例(n = 8,062)。根据出生年份选取正常体重对照组(n = 8,062)。采用逻辑回归分析评估孕期体重指数(BMI)变化及其他母体因素导致SGA的风险。
孕期BMI增加会降低SGA风险(调整比值比 = 0.8;95%置信区间0.7, 1.0)。其他风险因素包括既往SGA(4.4;4.0, 4.8)、子痫前期/子痫(2.6;2.1, 3.2)、母体心脏病(1.8;1.1, 2.9)、体重增加不足(1.9;1.8, 2.2)以及吸烟(每天1 - 9支香烟,调整比值比为1.9;1.7, 2.3;每天10 - 19支,调整比值比为2.5;2.2, 2.8;每天20支及以上,调整比值比为2.8;2.5, 3.3)。
孕期BMI增加可降低SGA风险,但孕期适当增加体重更为有效。