MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
School of Public Health, Shanghai Jiaotong University, Shanghai, China.
J Hum Hypertens. 2018 May;32(5):349-358. doi: 10.1038/s41371-018-0035-4. Epub 2018 Feb 23.
Interpregnancy interval and maternal age are associated with birth outcomes. However, it is unknown regarding their long-term effects on child health. We aim to assess the associations between interpregnancy interval and offspring's body mass index (BMI) and blood pressure (BP) at age of 7 years and to examine the role of maternal age in the associations. A secondary analysis was performed among 2604 mother-infant pairs in the prospective National Collaborative Perinatal Project, in which the children were followed up until 7 yrs of age. Interpregnancy interval was positively associated with offspring's diastolic BP at 7 yrs (β = 0.053, 95% CI: 0.004-0.102) after adjusting for maternal and perinatal characteristics, feeding pattern, rapid weight gain in the first year of life, and current BMI z score and height z score. The inclusion of maternal age in the model did not change the effect size. Maternal age was independently associated with offspring's BMI z score at 7 yrs (β = 0.014, 95% CI: 0.001-0.027). An interaction between interpregnancy interval and maternal age was present in the association with diastolic BP (P = 0.019), and the increasing maternal age aggravated the effects of long interpregnancy interval. Our finding suggests long interpregnancy interval is a risk factor for higher diastolic BP of the offspring. Increasing maternal age could amplify the impact. Our study challenges the current WHO recommendation for ideal interpregnancy interval, and we would suggest lowering the recommendation to <24 months and even shorter for women of advanced age.
两次妊娠间隔时间和母亲年龄与生育结局有关。然而,其对儿童健康的长期影响尚不清楚。我们旨在评估两次妊娠间隔时间与 7 岁时后代的体重指数(BMI)和血压(BP)之间的关联,并探讨母亲年龄在这些关联中的作用。对前瞻性全国合作围产儿项目中的 2604 对母婴进行了二次分析,该项目对儿童进行了随访,直到 7 岁。调整了母亲和围产期特征、喂养模式、生命第一年的快速体重增加以及当前 BMI z 评分和身高 z 评分后,两次妊娠间隔时间与 7 岁时后代的舒张压呈正相关(β=0.053,95%CI:0.004-0.102)。在模型中纳入母亲年龄并没有改变效应大小。母亲年龄与 7 岁时后代的 BMI z 评分独立相关(β=0.014,95%CI:0.001-0.027)。两次妊娠间隔时间与母亲年龄之间存在与舒张压相关的交互作用(P=0.019),随着母亲年龄的增加,长两次妊娠间隔时间的影响加剧。我们的研究结果表明,长两次妊娠间隔时间是后代舒张压升高的危险因素。增加母亲年龄可能会放大这种影响。我们的研究对当前世卫组织关于理想两次妊娠间隔时间的建议提出了挑战,我们建议将其降低至<24 个月,甚至对于高龄产妇来说更短。