Division of Preventive, Occupational and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota, USA.
J Adolesc Health. 2010 Jan;46(1):77-82. doi: 10.1016/j.jadohealth.2009.06.006. Epub 2009 Aug 13.
To determine the joint effect of young maternal age and obesity status on the risk of preeclampsia and eclampsia among a large cohort of singleton pregnancies.
Data were obtained from birth cohort files recorded in the state of Florida during the years 2004-2007. The study sample consisted of mothers aged 13-24 (n = 290,807), divided into four obesity categories on the basis of prepregnancy body mass index (BMI): nonobese (BMI < 30), Class I obese (30.0 < or = BMI > or = 34.9), Class II obese (35.0 < or = BMI > or = 39.9), and extreme obesity (BMI > or = 40). Nonobese mothers (BMI < 30) between the ages of 20 and 24 years were the reference group. Logistic regression models were generated to adjust for the association between preeclampsia, obesity, and maternal age with sociodemographic variables and pregnancy complications as covariates.
The overall prevalence of preeclampsia in the study population was 5.0%. The risk of preeclampsia and eclampsia increased significantly with increasing BMI and decreasing age. Extremely obese teenagers were almost four times as likely to develop preeclampsia and eclampsia compared with nonobese women aged 20-24 years (adjusted odds ratio [95% confidence interval] = 3.79 [3.15-4.55]). Whereas obesity elevated the risk for preeclampsia and eclampsia among all women in the study, teenagers were most at risk because of the combined effects of young age and obesity.
Effective obesity prevention strategies should continue to be advocated for all teenagers, in addition to innovative approaches to teenage pregnancy prevention.
在一项大型单胎妊娠队列中，确定年轻母亲年龄和肥胖状况对先兆子痫和子痫风险的联合影响。
数据来自 2004 年至 2007 年期间佛罗里达州记录的出生队列文件。研究样本由年龄在 13-24 岁的母亲组成（n=290807），根据孕前体重指数（BMI）分为四个肥胖类别：非肥胖（BMI<30）、I 类肥胖（30.0<或=BMI>或=34.9）、II 类肥胖（35.0<或=BMI>或=39.9）和极度肥胖（BMI>或=40）。20-24 岁的非肥胖母亲（BMI<30）为参考组。生成逻辑回归模型，以调整先兆子痫、肥胖和母亲年龄与社会人口统计学变量和妊娠并发症的关联，将其作为协变量。
研究人群中先兆子痫的总体患病率为 5.0%。随着 BMI 的增加和年龄的降低，先兆子痫和子痫的风险显著增加。与 20-24 岁非肥胖女性相比，极度肥胖的青少年发生先兆子痫和子痫的风险几乎增加了四倍（调整后的优势比[95%置信区间]为 3.79[3.15-4.55]）。肥胖增加了所有研究女性发生先兆子痫和子痫的风险，但青少年由于年龄和肥胖的综合影响，风险最高。
除了青少年妊娠预防的创新方法外，还应继续倡导为所有青少年制定有效的肥胖预防策略。
