Atreya Mihir R, Muglia Louis J, Greenberg James M, DeFranco Emily A
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Matern Child Health J. 2017 Mar;21(3):562-570. doi: 10.1007/s10995-016-2140-8.
Objectives Assess the influence of maternal race on the association between interpregnancy interval (IPI) and risk of small for gestational age (SGA) and large for gestational age (LGA) births. Methods Statewide population-based cohort study of 380,520 singleton births. We calculated risk of SGA and LGA births following IPIs of 0 to <6, 6 to <12, 12 to <24 (referent), 24 to <60 months, and ≥60 months, by maternal race after adjustment for confounding influences. Results The highest risk for SGA among white women followed short IPI of 0 to <6 months [adjRR 1.14 (95 % CI 1.08-1.21)], and long IPI ≥ 60 months [adjRR 1.37 (95 % CI 1.31-1.43)]. Only long IPI ≥ 60 months increased SGA risk in black women [adjRR 1.22 (95 % CI 1.13-1.32)]. LGA risk in white women was lowest with shortest and longest IPIs, 0 to <6 [adjRR 0.80 (95 % CI 0.76-0.84)] and ≥60 months [adjRR 0.68 (95 % CI 0.66-0.70)]. The crude risk of LGA was directly proportional to longer IPIs in black women. However, after adjusting for confounding effects of age, obesity, excessive gestational weight gain, and gestational diabetes, the effect was reversed to reduced risk following long IPI ≥ 60 months [adjRR 0.82 (95 % CI 0.74-0.91)], similar to that of white women. Conclusions In black and white women, an interpregnancy interval of 1-2 years is associated with optimal fetal growth. In addition to birth spacing, addressing modifiable factors such as pre-pregnancy BMI, monitoring gestational weight gain, and control of gestational diabetes in black women may help optimize fetal growth.
目的 评估母亲种族对妊娠间隔（IPI）与小于胎龄儿（SGA）及大于胎龄儿（LGA）出生风险之间关联的影响。方法 基于全州人口的队列研究，纳入380,520例单胎分娩。在调整混杂因素影响后，我们按母亲种族计算了IPI为0至<6个月、6至<12个月、12至<24个月（参照组）、24至<60个月及≥60个月后的SGA和LGA出生风险。结果 白人女性中，SGA风险最高的情况是IPI短于6个月（0至<6个月）[校正风险比（adjRR）1.14（95%置信区间1.08 - 1.21）]以及IPI长于60个月[adjRR 1.37（95%置信区间1.31 - 1.43）]。只有IPI长于60个月会增加黑人女性的SGA风险[adjRR 1.22（95%置信区间1.13 - 1.32）]。白人女性中，IPI最短（0至<6个月）和最长（≥60个月）时LGA风险最低，分别为[adjRR 0.80（95%置信区间）0.76 - 0.84]和[adjRR 0.68（95%置信区间0.66 - 0.70）]。黑人女性中，LGA的原始风险与较长的IPI成正比。然而，在调整年龄、肥胖、孕期体重过度增加和妊娠期糖尿病的混杂效应后，效应发生逆转，IPI长于60个月时风险降低[adjRR 0.82（95%置信区间0.74 - 0.91）]，与白人女性相似。结论 在黑人和白人女性中，1 - 2年的妊娠间隔与最佳胎儿生长相关。除了生育间隔外，解决一些可改变的因素，如孕前体重指数、监测孕期体重增加以及控制黑人女性的妊娠期糖尿病，可能有助于优化胎儿生长。
