母亲体重指数和孕期体重增加对妊娠并发症的影响：欧洲、北美和澳大利亚队列的个体参与者数据荟萃分析。
Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of European, North American and Australian cohorts.
机构信息
The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
出版信息
BJOG. 2019 Jul;126(8):984-995. doi: 10.1111/1471-0528.15661. Epub 2019 Mar 20.
OBJECTIVE
To assess the separate and combined associations of maternal pre-pregnancy body mass index (BMI) and gestational weight gain with the risks of pregnancy complications and their population impact.
DESIGN
Individual participant data meta-analysis of 39 cohorts.
SETTING
Europe, North America, and Oceania.
POPULATION
265 270 births.
METHODS
Information on maternal pre-pregnancy BMI, gestational weight gain, and pregnancy complications was obtained. Multilevel binary logistic regression models were used.
MAIN OUTCOME MEASURES
Gestational hypertension, pre-eclampsia, gestational diabetes, preterm birth, small and large for gestational age at birth.
RESULTS
Higher maternal pre-pregnancy BMI and gestational weight gain were, across their full ranges, associated with higher risks of gestational hypertensive disorders, gestational diabetes, and large for gestational age at birth. Preterm birth risk was higher at lower and higher BMI and weight gain. Compared with normal weight mothers with medium gestational weight gain, obese mothers with high gestational weight gain had the highest risk of any pregnancy complication (odds ratio 2.51, 95% CI 2.31- 2.74). We estimated that 23.9% of any pregnancy complication was attributable to maternal overweight/obesity and 31.6% of large for gestational age infants was attributable to excessive gestational weight gain.
CONCLUSIONS
Maternal pre-pregnancy BMI and gestational weight gain are, across their full ranges, associated with risks of pregnancy complications. Obese mothers with high gestational weight gain are at the highest risk of pregnancy complications. Promoting a healthy pre-pregnancy BMI and gestational weight gain may reduce the burden of pregnancy complications and ultimately the risk of maternal and neonatal morbidity.
TWEETABLE ABSTRACT
Promoting a healthy body mass index and gestational weight gain might reduce the population burden of pregnancy complications.
目的
评估母体孕前体重指数（BMI）和妊娠期体重增加分别和联合与妊娠并发症风险的关联，以及其对人群的影响。
设计
欧洲、北美和大洋洲 39 项队列的个体参与者数据荟萃分析。
地点
欧洲、北美和大洋洲。
人群
265270 例分娩。
方法
获取关于母体孕前 BMI、妊娠期体重增加和妊娠并发症的信息。采用多水平二项逻辑回归模型。
主要结局测量指标
妊娠期高血压、先兆子痫、妊娠期糖尿病、早产、出生时小于胎龄儿和大于胎龄儿。
结果
在整个范围内，较高的母体孕前 BMI 和妊娠期体重增加与妊娠期高血压疾病、妊娠期糖尿病和出生时大于胎龄儿的风险增加相关。较低和较高 BMI 以及体重增加与早产风险增加相关。与体重正常、妊娠期体重增加适中的母亲相比，妊娠期体重增加较高的肥胖母亲发生任何妊娠并发症的风险最高（比值比 2.51，95%CI 2.31-2.74）。我们估计，23.9%的任何妊娠并发症归因于母体超重/肥胖，31.6%的大于胎龄儿归因于妊娠期体重过度增加。
结论
在整个范围内，母体孕前 BMI 和妊娠期体重增加与妊娠并发症的风险相关。妊娠期体重增加较高的肥胖母亲发生妊娠并发症的风险最高。促进健康的孕前 BMI 和妊娠期体重增加可能会降低妊娠并发症的人群负担，最终降低母婴发病率的风险。
推文摘要
促进健康的体重指数和妊娠期体重增加可能会降低妊娠并发症的人群负担。
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