Department of Neurology, University of California, San Francisco, San Francisco, CA.
J Pediatr. 2013 Nov;163(5):1307-12. doi: 10.1016/j.jpeds.2013.06.062. Epub 2013 Aug 6.
To examine the association between maternal hospital diagnoses of obesity and risk of cerebral palsy (CP) in the child.
For all California hospital births from 1991-2001, we linked infant and maternal hospitalization discharge abstracts to California Department of Developmental Services records of children receiving services for CP. We identified maternal hospital discharge diagnoses of obesity (International Classification of Diseases, 9th edition 646.1, 278.00, or 278.01) and morbid obesity (International Classification of Diseases, 9th edition 278.01), and performed logistic regression to explore the relationship between maternal obesity diagnoses and CP.
Among 6.2 million births, 67 200 (1.1%) mothers were diagnosed with obesity, and 7878 (0.1%) with morbid obesity; 8798 (0.14%) children had CP. A maternal diagnosis of obesity (relative risk [RR] 1.30, 95% CI 1.09-1.55) or morbid obesity (RR 2.70, 95% CI 1.89-3.86) was associated with increased risk of CP. In multivariable analysis adjusting for maternal race, age, education, prenatal care, insurance status, and infant sex, both obesity (OR 1.27, 95% CI 1.06-1.52) and morbid obesity (OR 2.56, 95% CI 1.79-3.66) remained independently associated with CP. On stratified analyses, the association of obesity (RR 1.72, 95% CI 1.25-2.35) or morbid obesity (RR 3.79, 95% CI 2.35-6.10) with CP was only significant among women who were hospitalized prior to the birth admission. Adjusting for potential comorbidities and complications of obesity did not eliminate this association.
Maternal obesity may confer an increased risk of CP in some cases. Further studies are needed to confirm this finding.
研究母亲在医院被诊断为肥胖与儿童脑瘫(CP)风险之间的关系。
对于 1991 年至 2001 年所有在加州住院分娩的婴儿,我们将婴儿和产妇住院的出院记录与加州发育服务部记录的接受 CP 治疗的儿童服务记录相链接。我们确定了产妇在医院被诊断为肥胖(国际疾病分类第 9 版 646.1、278.00 或 278.01)和病态肥胖(国际疾病分类第 9 版 278.01)的出院诊断,并进行了逻辑回归分析,以探讨母亲肥胖诊断与 CP 之间的关系。
在 620 万例分娩中,有 67200 名(1.1%)母亲被诊断为肥胖,7878 名(0.1%)为病态肥胖;8798 名(0.14%)儿童患有 CP。母亲肥胖诊断(相对风险 [RR] 1.30,95%CI 1.09-1.55)或病态肥胖诊断(RR 2.70,95%CI 1.89-3.86)与 CP 风险增加相关。在调整了母亲种族、年龄、教育程度、产前护理、保险状况和婴儿性别等因素的多变量分析中,肥胖(OR 1.27,95%CI 1.06-1.52)和病态肥胖(OR 2.56,95%CI 1.79-3.66)均与 CP 独立相关。在分层分析中,肥胖(RR 1.72,95%CI 1.25-2.35)或病态肥胖(RR 3.79,95%CI 2.35-6.10)与 CP 的关联仅在分娩前住院的女性中具有统计学意义。调整肥胖的潜在合并症和并发症并不能消除这种关联。
在某些情况下,母亲肥胖可能会增加 CP 的风险。需要进一步的研究来证实这一发现。