Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
BJOG. 2018 May;125(6):676-684. doi: 10.1111/1471-0528.14859. Epub 2017 Oct 25.
To assess weight change and attempted weight loss during the 12-18 months before spontaneous conception in relation to the risk of pregnancy loss.
Prospective cohort study.
United States, 2007-2011.
Women (n = 629) who were attempting pregnancy reported at baseline any weight loss attempts over the past 12 months, and their minimum and maximum weights during that time. Follow up lasted one to six menstrual cycles and throughout pregnancy. Using bodyweight measured at 4 weeks' gestation, participants were categorised as having weight loss ≥5%, weight gain ≥5%, both, or neither, over the previous 12-18 months. Log-binomial models adjusted for potential confounders.
Risk ratio (RR) and 95% confidence interval (CI) of pregnancy loss.
Attempted weight loss was reported by 44% of women and actual weight loss by 11%, but neither was consistently associated with pregnancy loss. The RR for recent weight gain ≥5% was 1.65 (CI 1.09, 2.49).
Weight gain over the period spanning 12-18 months pre-conception to 4 weeks' gestation may increase the risk of pregnancy loss among fertile women with prior pregnancy losses. Attempted and actual weight loss were not associated with pregnancy loss; however, replication is needed from larger studies with data on particular weight-loss methods.
Recent weight gain before and around the time of conception may increase the risk of pregnancy loss.
评估自发受孕前 12-18 个月的体重变化和尝试减重与流产风险的关系。
前瞻性队列研究。
美国，2007-2011 年。
尝试妊娠的女性（n=629）在基线时报告过去 12 个月内的任何减重尝试，并报告这段时间内的最低和最高体重。随访持续 1 至 6 个月经周期和整个妊娠过程。根据受孕后 4 周的体重，参与者被分为在过去 12-18 个月内体重减轻≥5%、体重增加≥5%、两者兼有或两者均无。使用多因素log-binomial 模型调整潜在混杂因素。
流产的风险比（RR）和 95%置信区间（CI）。
44%的女性报告有减重尝试，11%的女性有实际体重减轻，但两者与流产均无明显相关性。近期体重增加≥5%的 RR 为 1.65（95%CI 1.09，2.49）。
受孕前 12-18 个月至受孕后 4 周期间的体重增加可能会增加有既往流产史的生育期女性的流产风险。尝试减重和实际减重与流产无关；然而，需要更大规模的研究来验证，并且需要有特定减重方法的数据。
受孕前后的近期体重增加可能会增加流产风险。
