中国广西孕妇体重指数与血红蛋白浓度对血压的相互作用
Interaction of body mass index and hemoglobin concentration on blood pressure among pregnant women in Guangxi, China.
作者信息
Zhong Qiuan, Xu Jiangyan, Long Yingquan, Deng Yingying, Hu Jinlan, Li Xiaofei, Qiu Xiaoqiang
机构信息
Department of Epidemiology, Guangxi Medical University School of Public Health, 22 Shuangyong Road, Nanning, Guangxi 530021, China.
出版信息
BMC Public Health. 2014 May 20;14:474. doi: 10.1186/1471-2458-14-474.
BACKGROUND
Body mass index (BMI) and hemoglobin (Hb) are positively associated with hypertensive disorders among pregnant women. The aim of this study was to estimate a potential interaction between high BMI and high Hb concentrations on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in pregnancy.
METHODS
We recruited 4497 single-birth women aged 18-43 years who received routine antenatal care at three hospitals of Guigang, Guangxi, China, from December 2007 to January 2011. Of 4497 participants, 3472 women were in the first trimester, with following up, 2986 women and 2261 women were left in the second and third trimester, respectively. Clinical data were derived from medical records of each woman. We used multivariable linear regression, by trimesters of pregnancy, to evaluate the associations of high BMI and high Hb concentrations with SBP and DBP according to cross-sectional design.
RESULTS
In multivariable analyses, BMI was positively associated with SBP throughout all trimesters, but the corresponding association for Hb concentrations only in the first trimester, whereas both BMI and Hb concentrations were positively associated with DBP in the first and third trimesters. After full adjustment for confounding, the average differences in SBP and DBP comparing women with high BMI and high Hb to those with non-high BMI and non-high Hb were 2.9 mmHg (95% CI: 0.8 to 5.0 mmHg) and 3.9 mmHg (95% CI: 1.5 to 6.3 mmHg) in the first trimester, 2.6 mmHg (95% CI: 0.4 to 4.8 mmHg) and 1.5 mmHg (95% CI: -1.3 to 4.3 mmHg) in the second trimester, and 4.8 mmHg (95% CI: 2.3 to 7.4 mmHg) and 5.7 mmHg (95% CI: 3.2 to 8.3 mmHg) in the third trimester, respectively. With respect to the interaction, significant combined effects between high BMI and high Hb were confirmed on SBP (P = 0.02) and DBP (P = 0.004) in the third trimester, and the amount of interaction on SBP and DBP were 2.0 mmHg (95% CI: 0.1 to 3.9 mmHg) and 2.3 mmHg (95% CI: 0.4 to 4.3 mmHg), respectively.
CONCLUSION
Our findings suggest that high BMI and high Hb concentrations may have a synergistic effect on blood pressure in late stage of pregnancy.
背景
体重指数（BMI）和血红蛋白（Hb）与孕妇高血压疾病呈正相关。本研究的目的是评估高BMI和高Hb浓度对孕期收缩压（SBP）和舒张压（DBP）的潜在相互作用。
方法
我们招募了4497名单胎分娩的18 - 43岁女性，她们于2007年12月至2011年1月在中国广西贵港的三家医院接受常规产前检查。在4497名参与者中，3472名女性处于孕早期，经过随访，分别有2986名和2261名女性留在孕中期和孕晚期。临床数据来自每位女性的病历。我们采用多变量线性回归，按孕期阶段，根据横断面设计评估高BMI和高Hb浓度与SBP和DBP的关联。
结果
在多变量分析中，BMI在所有孕期阶段均与SBP呈正相关，但Hb浓度仅在孕早期有相应关联，而BMI和Hb浓度在孕早期和孕晚期均与DBP呈正相关。在对混杂因素进行全面调整后，将高BMI和高Hb的女性与非高BMI和非高Hb的女性相比，孕早期SBP和DBP的平均差异分别为2.9 mmHg（95%CI：0.8至5.0 mmHg）和3.9 mmHg（95%CI：1.5至6.3 mmHg），孕中期分别为2.6 mmHg（95%CI：0.4至4.8 mmHg）和1.5 mmHg（95%CI： - 1.3至4.3 mmHg），孕晚期分别为4.8 mmHg（95%CI：2.3至7.4 mmHg）和5.7 mmHg（95%CI：3.2至8.3 mmHg）。关于相互作用，在孕晚期，高BMI和高Hb之间在SBP（P = 0.02）和DBP（P = 0.004）上被证实存在显著的联合效应，SBP和DBP上的相互作用量分别为2.0 mmHg（95%CI：0.1至3.9 mmHg）和2.3 mmHg（95%CI：0.4至4.3 mmHg）。
结论
我们的研究结果表明，高BMI和高Hb浓度可能在妊娠晚期对血压产生协同作用。
Zotero 插件