Reiss Katharina, Breckenkamp Jürgen, Borde Theda, Brenne Silke, David Matthias, Razum Oliver
1 Department of Epidemiology & International Public Health, Bielefeld School of Public Health (BiSPH), Bielefeld University, Bielefeld, Germany.
1 Department of Epidemiology & International Public Health, Bielefeld School of Public Health (BiSPH), Bielefeld University, Bielefeld, Germany
Eur J Public Health. 2015 Oct;25(5):839-44. doi: 10.1093/eurpub/ckv072. Epub 2015 Apr 13.
Maternal excessive weight and smoking are associated with an increased risk of pregnancy complications and adverse pregnancy outcomes. In Germany, immigrant women have a higher prevalence of pre-pregnancy overweight/obesity compared with autochthonous women. We compared the contribution of pre-pregnancy overweight/obesity to adverse pregnancy outcomes among immigrant and autochthonous women in Berlin/Germany.
Data from 2586 immigrant women (from Turkey, Lebanon, other countries of origin) and 2676 autochthonous women delivering in three maternity hospitals of Berlin within 12 months (2011/2012) was used. Cox regression models were applied to estimate the association between overweight/obesity and smoking with the outcomes large-for-gestational-age (LGA), small-for-gestational-age (SGA), preterm birth (PTB) and extreme preterm-birth (E-PTB). Population attributive fractions (PAF) were calculated to quantify the proportion of the outcomes attributable to overweight/obesity and smoking, respectively.
Prevalence of overweight and obesity was 33.4% among autochthonous and 53.6% among Turkish women. Prevalence risk ratios of excessive weight were highest for LGA infants among immigrant and autochthonous women. The PAFs were -11.8% (SGA), +16.3% (LGA), +3.6% (PTB) and +16.5% (E-PTB) for the total study population.
Overweight/obesity is strongly associated with an increased risk of delivering an LGA infant among both immigrant and autochthonous women. Compared with autochthonous women, the contribution of excessive weight to LGA is even higher among immigrant women, in whom PAFs of overweight/obesity even exceed those of smoking for some outcomes.
孕妇体重超标和吸烟与妊娠并发症及不良妊娠结局风险增加有关。在德国，与本地女性相比，移民女性孕前超重/肥胖的患病率更高。我们比较了德国柏林移民女性和本地女性中孕前超重/肥胖对不良妊娠结局的影响。
使用了2011/2012年12个月内在柏林三家妇产医院分娩的2586名移民女性（来自土耳其、黎巴嫩及其他原籍国）和2676名本地女性的数据。应用Cox回归模型来估计超重/肥胖及吸烟与巨大儿（LGA）、小于胎龄儿（SGA）、早产（PTB）和极早早产（E-PTB）结局之间的关联。计算人群归因分数（PAF）以分别量化可归因于超重/肥胖和吸烟的结局比例。
本地女性中超重和肥胖的患病率为33.4%，土耳其女性中为53.6%。移民和本地女性中，LGA婴儿的超重患病率风险比最高。整个研究人群的PAF分别为：-11.8%（SGA）、+16.3%（LGA）、+3.6%（PTB）和+16.5%（E-PTB）。
超重/肥胖与移民和本地女性分娩LGA婴儿的风险增加密切相关。与本地女性相比，超重对移民女性LGA的影响甚至更高，在某些结局中，超重/肥胖的PAF甚至超过了吸烟的PAF。
