Stotland Naomi E, Caughey Aaron B, Lahiff Maureen, Abrams Barbara
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco General Hospital, California 94110, USA.
Obstet Gynecol. 2006 Dec;108(6):1448-55. doi: 10.1097/01.AOG.0000247175.63481.5f.
To study how the relationship between gestational weight gain and spontaneous preterm birth interacts with maternal race or ethnicity and previous preterm birth status.
This was a retrospective cohort study of singleton births to women of normal or low prepregnancy body mass index. Gestational weight gain was measured as total weight gain divided by weeks of gestation at delivery, and weight gain was categorized as low (less than 0.27 kg/wk,), normal (0.27-0.52 kg/wk), or high (more than 0.52 kg/wk). Univariable and multivariable analyses were performed on the relationship between weight gain categories and spontaneous preterm birth, stratified by maternal race or ethnicity and history of previous preterm birth.
Overall, low weight gain was associated with spontaneous preterm birth (adjusted odds ratio [AOR] 2.5, 95% confidence interval [CI] 2.0-3.1). Although low gain was consistently associated with increased spontaneous preterm birth, some differences were found in subgroup analysis. Among African Americans with a previous preterm birth, both low and high weight gain were associated with increased odds of spontaneous preterm birth (AOR for low weight gain 4.3, 95% CI 1.2-15.5; AOR for high weight gain 6.1, 95% CI 1.8-20.2). For all other groups, high weight gain was not associated with spontaneous preterm birth. Among Asians with a previous preterm birth, low weight gain was not statistically significantly associated with spontaneous preterm birth (AOR 1.9, 95% CI 0.5-7.7). Among Asians there was also a non-statistically significant inverse relationship between high weight gain and spontaneous preterm birth (AOR 0.5, 95% CI 0.3-1.1).
These results confirm an association between low maternal weight gain and spontaneous preterm birth. The effect modification of maternal race or ethnicity and history of previous preterm birth on this association deserves further study.
II-2.
研究孕期体重增加与自发性早产之间的关系如何与母亲的种族或族裔以及既往早产状况相互作用。
这是一项对孕前体重指数正常或偏低的单胎分娩女性进行的回顾性队列研究。孕期体重增加以分娩时的总体重增加量除以孕周来衡量，体重增加分为低（低于0.27千克/周）、正常（0.27 - 0.52千克/周）或高（高于0.52千克/周）。对体重增加类别与自发性早产之间的关系进行单变量和多变量分析，并按母亲的种族或族裔以及既往早产史进行分层。
总体而言，低体重增加与自发性早产相关（调整后的优势比[AOR]为2.5，95%置信区间[CI]为2.0 - 3.1）。虽然低体重增加一直与自发性早产风险增加相关，但在亚组分析中发现了一些差异。在有既往早产史的非裔美国人中，低体重增加和高体重增加均与自发性早产几率增加相关（低体重增加的AOR为4.3，95% CI为1.2 - 15.5；高体重增加的AOR为6.1，95% CI为1.8 - 20.2）。对于所有其他组，高体重增加与自发性早产无关。在有既往早产史的亚洲人中，低体重增加与自发性早产无统计学显著关联（AOR为1.9，95% CI为0.5 - 7.7）。在亚洲人中，高体重增加与自发性早产之间也存在非统计学显著的负相关关系（AOR为0.5，95% CI为0.3 - 1.1）。
这些结果证实了母亲低体重增加与自发性早产之间的关联。母亲种族或族裔以及既往早产史对这种关联的效应修饰值得进一步研究。
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