Department of Paediatrics, University ofMontréal, Montréal, Quebec, Canada.
CMAJ. 2012 Nov 6;184(16):1777-84. doi: 10.1503/cmaj.120143. Epub 2012 Sep 24.
Adults who were born with low birth weights are at increased risk of cardiovascular and metabolic conditions, including pregnancy complications. Low birth weight can result from intrauterine growth restriction, preterm birth or both. We examined the relation between preterm birth and pregnancy complications later in life.
We conducted a population-based cohort study in the province of Quebec involving 7405 women born preterm (554 < 32 weeks, 6851 at 32-36 weeks) and a matched cohort of 16 714 born at term between 1976 and 1995 who had a live birth or stillbirth between 1987 and 2008. The primary outcome measures were pregnancy complications (gestational diabetes, gestational hypertension, and preeclampsia or eclampsia).
Overall, 19.9% of women born at less than 32 weeks, 13.2% born at 32-36 weeks and 11.7% born at term had at least 1 pregnancy complication at least once during the study period (p < 0.001). Women born small for gestational age (both term and preterm) had increased odds of having at least 1 pregnancy complication compared with women born at term and at appropriate weight for gestational age. After adjustment for various factors, including birth weight for gestational age, the odds of pregnancy complications associated with preterm birth was elevated by 1.95-fold (95% confidence interval [CI] 1.54-2.47) among women born before 32 weeks' gestation and 1.14-fold (95% CI 1.03-1.25) among those born at 32-36 weeks' gestation relative to women born at term.
Being born preterm, in addition to, and independent of, being small for gestational age, was associated with a significantly increased risk of later having pregnancy complications.
出生体重较低的成年人患心血管和代谢疾病的风险增加，包括妊娠并发症。低出生体重可能是由宫内生长受限、早产或两者共同导致的。我们研究了早产与成年后妊娠并发症之间的关系。
我们在魁北克省进行了一项基于人群的队列研究，涉及 7405 名早产儿（<32 周，554 名；32-36 周，6851 名）和 1976 年至 1995 年足月出生且在 1987 年至 2008 年期间活产或死产的 16714 名匹配队列，这些女性在研究期间至少有一次妊娠并发症（妊娠期糖尿病、妊娠高血压和子痫前期或子痫）。
总体而言，<32 周出生的女性中，19.9%；32-36 周出生的女性中，13.2%；足月出生的女性中，11.7%至少在研究期间有一次妊娠并发症（p<0.001）。与足月出生且体重适宜的女性相比，出生时小于胎龄（足月和早产）的女性发生至少一次妊娠并发症的可能性增加。在调整了包括胎龄体重在内的各种因素后，与足月出生的女性相比，<32 周出生的女性妊娠并发症的发生风险增加了 1.95 倍（95%置信区间[CI]1.54-2.47），而 32-36 周出生的女性妊娠并发症的发生风险增加了 1.14 倍（95%CI1.03-1.25）。
除了与胎龄相关的小体重外，早产本身与成年后患妊娠并发症的风险显著增加相关。
