Romundstad Pål R, Davey Smith George, Nilsen Tom I L, Vatten Lars J
Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway.
Am J Epidemiol. 2007 Dec 15;166(12):1359-64. doi: 10.1093/aje/kwm272. Epub 2007 Oct 31.
Low birth weight of offspring has been associated with increased risk of maternal cardiovascular mortality, and cardiovascular risk factors measured within pregnancy have been related to offspring birth weight. It is not clear whether cardiovascular risk factors assessed prior to pregnancy are associated with the offspring's birth weight. The authors combined baseline data from 3,461 women in the HUNT Study (1995-1997) and data on deliveries from the Medical Birth Registry of Norway up to 2005. They used linear regression to prospectively study associations between diastolic and systolic blood pressures, concentrations of triglycerides, serum total cholesterol, and high density lipoprotein cholesterol measured before conception and birth weight for gestational age of the offspring. Blood pressure measured before pregnancy was inversely associated with birth weight for gestational age, whereas unfavorable levels of serum total cholesterol, high density lipoprotein cholesterol, triglycerides, and glucose were positively associated with birth weight for gestational age. Thus, women with relatively high blood pressure tend to deliver small babies, whereas women with unfavorable lipid levels tend to give birth to large babies, suggesting reduced glucose tolerance. These findings suggest that low as well as high birth weight of the offspring may indicate increased cardiovascular risk for the mother.
子代低出生体重与母亲心血管疾病死亡风险增加相关,孕期所测的心血管危险因素与子代出生体重有关。目前尚不清楚妊娠前评估的心血管危险因素是否与子代出生体重相关。作者将HUNT研究(1995 - 1997年)中3461名女性的基线数据与挪威医疗出生登记处截至2005年的分娩数据相结合。他们使用线性回归前瞻性地研究受孕前测量的舒张压和收缩压、甘油三酯浓度、血清总胆固醇和高密度脂蛋白胆固醇与子代出生体重和胎龄之间的关联。妊娠前测量的血压与胎龄出生体重呈负相关,而血清总胆固醇、高密度脂蛋白胆固醇、甘油三酯和葡萄糖的不良水平与胎龄出生体重呈正相关。因此,血压相对较高的女性往往会生出体重较轻的婴儿,而血脂水平不良的女性往往会生出体重较重的婴儿,这表明葡萄糖耐量降低。这些发现表明,子代出生体重过低或过高都可能表明母亲心血管疾病风险增加。