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孕前超重、孕期体重过度增加对巨大儿风险的前瞻性队列研究

[Prospective cohort study on the risks of pre-pregnancy overweight, excessive gestational weight gain on macrosomia].

作者信息

Zhang Z P, Chu L M, Chu S L, Lu M, Shen L H, Chen K, Gu L F, Wu H T, Shen J

机构信息

Department of Obstetrics and Gynecology, Shanghai Pudong New Area Healthcare Hospital for Women and Children, Shanghai, 201206, China.

Key Laboratory of Reproduction Regulation of National Population and Family Planning Commission, Shanghai Institute of Planned Parenthood Research, Institute of Reproductive and Developmental Studies, Fudan University, Shanghai, 200032, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2018 Aug 10;39(8):1082-1085. doi: 10.3760/cma.j.issn.0254-6450.2018.08.013.

Abstract

To investigate the risks of pre-pregnancy overweight, excessive gestational weight gain on macrosomia. We conducted one hospital-based cohort study, focusing on pregnant women from January 2015. All pregnant women attending to this hospital for maternal check-ups, were included in our cohort and followed to the time of delivery. Data related to general demographic characteristics, pregnancy and health status of those pregnant women, was collected and maternal pre-pregnant BMI and maternal weight gain were calculated. Logistic regression was used to explore the risk difference of pre-pregnancy BMI, excessive gestational weight gain on macrosomia. The overall incidence of macrosomia in our cohort appeared as 6.6% (149/2 243). After adjusting the confounding factors including age and histories on pregnancy, pre-pregnancy overweight/obesity was associated with higher risks of macrosomia (=3.12, 95: 1.35-7.22, =0.008; =2.99, 95: 1.17-7.63, =0.022) when comparing to those with normal pre-pregnancy weight. Cesarean delivery and sex of the offspring were associated with higher risk of macrosomia, while excessive gestational weight gain showed no significant difference (=1.41, 95: 0.96-2.09, =0.084). Our data showed that Macrosomia was statistically associated with gestational weight gain (=0.002). After controlling parameters as age, history of pregnancy and related complications of the pregnant women, results from the logistic regression showed that women with gestational inadequate weight gain having reduced risks to deliver macrosomia, when compared to those pregnant women with adequate weight gain (=0.52, 95: 0.30-0.90, =0.019). Pre-pregnancy overweight and obesity were on higher risks to macrosomia.

摘要

为调查孕前超重、孕期体重过度增加与巨大儿的风险。我们开展了一项基于医院的队列研究,研究对象为2015年1月起的孕妇。所有到该医院进行产前检查的孕妇均纳入我们的队列,并随访至分娩时。收集了这些孕妇的一般人口统计学特征、妊娠及健康状况相关数据,并计算孕妇孕前体重指数和孕期体重增加情况。采用逻辑回归分析探讨孕前体重指数、孕期体重过度增加与巨大儿的风险差异。我们队列中巨大儿的总体发生率为6.6%(149/2243)。在调整包括年龄和妊娠史等混杂因素后,与孕前体重正常者相比,孕前超重/肥胖与巨大儿风险较高相关(比值比=3.12,95%置信区间:1.35 - 7.22,P = 0.008;比值比=2.99,95%置信区间:1.17 - 7.63,P = 0.022)。剖宫产和胎儿性别与巨大儿风险较高相关,而孕期体重过度增加无显著差异(比值比=1.41,95%置信区间:0.96 - 2.09,P = 0.084)。我们的数据显示巨大儿与孕期体重增加有统计学关联(P = 0.002)。在控制孕妇年龄、妊娠史及相关并发症等参数后,逻辑回归结果显示,与体重增加适当的孕妇相比,孕期体重增加不足的孕妇分娩巨大儿的风险降低(比值比=0.52,95%置信区间:0.30 - 0.90,P = 0.019)。孕前超重和肥胖发生巨大儿的风险较高。

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