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[孕前体重指数与孕妇孕期体重增加对新生儿出生体重的关联及相互作用]

[Association and interaction of pre-pregnant body mass index and gestational weight gain of women on neonatal birthweight].

作者信息

Lin Y J, Cai Q Y, Xu Y Y, Liu H Y, Han W H, Wang Y, Tan Y, Xiong H Y, Hu A Q, Zheng Y J

机构信息

Department of Public Health Microbiology, School of Public Health, Fudan University, Shanghai 200032, China;Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China.

Department of Public Health Microbiology, School of Public Health, Fudan University, Shanghai 200032, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Jun 10;39(6):770-775. doi: 10.3760/cma.j.issn.0254-6450.2018.06.015.

Abstract

To investigate the association between maternal pre-pregnant body mass index and gestational weight gain, as well as their interaction on neonatal birthweight. We built a cohort in Anqing Municipal Hospital from January 2014 to March 2015, enrolling pregnant women who decided to give birth in this hospital. All women were asked to fill a questionnaire for basic information collection. Medical information of both pregnant women and their newborns were obtained through electronic medical record. Chi-square analysis, multinomial logistic regression, multiplicative and additive interaction methods were used to analyze the association between pre-pregnant body mass index and gestational weight gain as well as their interactions on birth weight of the neonates. A total of 2 881 pregnant women were included in this study. Of the 2 881 newborns, 359 (12.46) were small for gestational age (SGA) and 273 (9.48) were large for gestational age (LGA). After adjusting the possible confounding factors, results from the multinomial logistic regression showed that pre-pregnancy underweight women were more possible to deliver SGA (a=1.33, 95: 1.02-1.73). If the gestational weight gain was below the recommended criteria, the risk of SGA (a=1.64, 95: 1.23-2.19) might increase. Pre-pregnancy overweight/obese could increase the risk of being LGA (a=1.86, 95: 1.33-2.60). Maternal gestational weight gain above the recommendation level was associated with higher rates of LGA (a=2.03, 95: 1.49-2.78). Results from the interaction analysis showed that there appeared no significant interaction between pre-pregnancy BMI and gestational weight on birthweight. Pre-pregnancy body mass index and gestational weight gain were independently associated with neonatal birthweight while pre-pregnancy BMI and gestational weight gain did not present interaction on birthweight.

摘要

探讨孕前体重指数与孕期体重增加之间的关联,以及它们对新生儿出生体重的交互作用。我们于2014年1月至2015年3月在安庆市立医院建立了一个队列,纳入决定在本院分娩的孕妇。所有女性均被要求填写一份问卷以收集基本信息。通过电子病历获取孕妇及其新生儿的医疗信息。采用卡方分析、多项逻辑回归、乘法和加法交互作用方法分析孕前体重指数与孕期体重增加之间的关联以及它们对新生儿出生体重的交互作用。本研究共纳入2881名孕妇。在这2881例新生儿中,359例(12.46%)为小于胎龄儿(SGA),273例(9.48%)为大于胎龄儿(LGA)。在调整可能的混杂因素后,多项逻辑回归结果显示,孕前体重过轻的女性更有可能分娩SGA(a=1.33,95%CI:1.02-1.73)。如果孕期体重增加低于推荐标准,SGA的风险(a=1.64,95%CI:1.23-2.19)可能会增加。孕前超重/肥胖会增加LGA的风险(a=1.86,95%CI:1.33-2.60)。孕妇孕期体重增加高于推荐水平与LGA的发生率较高相关(a=2.03,95%CI:1.49-2.78)。交互作用分析结果显示,孕前BMI与孕期体重对出生体重之间未出现显著交互作用。孕前体重指数和孕期体重增加与新生儿出生体重独立相关,而孕前BMI和孕期体重增加在出生体重方面未表现出交互作用。

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