子痫前期的风险随着孕前体重指数的增加而上升。

The risk of preeclampsia rises with increasing prepregnancy body mass index.

作者信息

Bodnar Lisa M, Ness Roberta B, Markovic Nina, Roberts James M

机构信息

Magee-Womens Research Institute, Pittsburgh, PA, USA.

出版信息

Ann Epidemiol. 2005 Aug;15(7):475-82. doi: 10.1016/j.annepidem.2004.12.008.

DOI:10.1016/j.annepidem.2004.12.008

PMID:16029839

Abstract

PURPOSE

To explore the dose-dependent relation between prepregnancy body mass index (BMI) and the risk of preeclampsia after adjusting for measured confounders.

METHODS

We studied 1179 primiparous women who enrolled at < 16 weeks' gestation into a prospective cohort study of the pathogenesis of preeclampsia. Multivariable logistic regression was used to quantify the independent effect of prepregnancy BMI on the risk of preeclampsia after adjusting for race and smoking status. BMI was specified as a restricted quadratic spline.

RESULTS

Preeclampsia risk rose strikingly from a BMI of 15 to 30 kg/m(2). Compared with women with a BMI of 21, the adjusted risk of preeclampsia doubled at a BMI of 26 (odds ratio 2.1 [95% confidence interval, 1.4, 3.4]), and nearly tripled at a BMI of 30 (2.9 [1.6, 5.3]). Women with a BMI of 17 had a 57% reduction in preeclampsia risk compared with women with a BMI of 21 (0.43 [0.25, 0.76]), and a BMI of 19 was associated with a 33% reduction in risk (0.66 [0.50, 0.87]).

CONCLUSIONS

These results indicate that preeclampsia risk rises through most of the BMI distribution. The dramatic elevation in overweight prevalence in the United States may increase preeclampsia incidence in the future.

摘要

目的

在对已测量的混杂因素进行校正后，探讨孕前体重指数（BMI）与子痫前期风险之间的剂量依赖关系。

方法

我们研究了1179名初产妇，她们在妊娠16周前纳入了一项关于子痫前期发病机制的前瞻性队列研究。多变量逻辑回归用于在对种族和吸烟状况进行校正后，量化孕前BMI对子痫前期风险的独立影响。BMI被指定为受限二次样条。

结果

子痫前期风险从BMI为15 kg/m²显著上升至30 kg/m²。与BMI为21的女性相比，BMI为26时子痫前期的校正风险增加了一倍（比值比2.1 [95%置信区间，1.4, 3.4]），BMI为30时几乎增加了两倍（2.9 [1.6, 5.3]）。与BMI为21的女性相比，BMI为17的女性子痫前期风险降低了57%（0.43 [0.25, 0.76]），BMI为19与风险降低33%相关（0.66 [0.50, 0.87]）。