Smid Marcela C, Ahmed Yusuf, Stoner Marie C D, Vwalika Bellington, Stringer Elizabeth M, Stringer Jeffrey S A
Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Obstetrics and Gynaecology, University of Zambia School of Medicine, Lusaka, Zambia.
Int J Gynaecol Obstet. 2017 Feb;136(2):188-194. doi: 10.1002/ijgo.12040. Epub 2016 Nov 30.
To evaluate the association between severity of prior low birth weight (LBW) delivery and adverse perinatal outcomes in the subsequent delivery among an HIV-prevalent urban African population.
A retrospective cohort study was conducted among 41 109 women who had undergone two deliveries in Lusaka, Zambia, between February 1, 2006, and May 31, 2013. The relationship between prior LBW delivery (<2500 g) and a composite measure of adverse perinatal outcome in the second pregnancy was assessed using multivariate logistic regression.
Women with prior LBW delivery (n=4259) had an increased risk of LBW in the second delivery versus those without prior LBW delivery (n=37 642). Such risk correlated with the severity of first delivery LBW. The adjusted odds ratio (AOR) was 2.89 (95% confidence interval [CI] 2.05-4.09) for a birth weight of 1000-1499 g, 3.05 (95% CI 2.42-3.86) for a birth weight of 1500-1999 g, and 2.02 (95% CI 1.81-2.27) for a birth weight of 2000-2499 g. Previous LBW delivery also increased the risk of adverse perinatal outcome, with an AOR of 1.4 (95% CI 1.2-1.7).
Severe prior LBW delivery conferred substantial risk for adverse perinatal outcomes in a subsequent pregnancy.
评估非洲城市地区艾滋病流行人群中，既往低体重儿（LBW）分娩的严重程度与后续分娩中不良围产期结局之间的关联。
对2006年2月1日至2013年5月31日期间在赞比亚卢萨卡进行过两次分娩的41109名女性进行回顾性队列研究。采用多因素logistic回归评估既往低体重儿分娩（<2500g）与第二次妊娠不良围产期结局综合指标之间的关系。
既往有低体重儿分娩史的女性（n = 4259）与无既往低体重儿分娩史的女性（n = 37642）相比，第二次分娩时低体重儿风险增加。这种风险与首次分娩低体重儿的严重程度相关。出生体重为1000 - 1499g时，调整后的优势比（AOR）为2.89（95%置信区间[CI] 2.05 - 4.09）；出生体重为1500 - 1999g时，AOR为3.05（95%CI 2.42 - 3.86）；出生体重为2000 - 2499g时，AOR为2.02（95%CI 1.81 - 2.27）。既往低体重儿分娩也增加了不良围产期结局的风险，AOR为1.4（95%CI 1.2 - 1.7）。
既往严重低体重儿分娩会使后续妊娠出现不良围产期结局的风险大幅增加。
