School of Public Health, Dalian Medical University, Dalian, Liaoning Province, 116044, People's Republic of China.
School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, People's Republic of China.
BMC Pregnancy Childbirth. 2019 Mar 29;19(1):105. doi: 10.1186/s12884-019-2249-z.
Maternal body mass index is linked to short- and long-term unfavorable health outcomes both for child and mother. We conducted a systematic review and meta-analysis of population-based cohort studies to evaluate maternal BMI and the risk of harmful neonatal outcomes in China.
Six databases identified 2454 articles; 46 met the inclusion criteria for this study. The dichotomous data on maternal BMI and harmful neonatal outcomes were extracted. Pooled statistics (odds ratios, ORs) were derived from Stata/SE, ver. 12.0. Sensitivity analyses assessed the robustness of the results. Meta-regression and subgroup meta-analyses explored heterogeneity.
The meta-analysis revealed that compared with normal BMI, high maternal BMI is associated with fetal overgrowth, defined as macrosomia ≥4000 g (OR 1.91, 95% CI 1.75-2.09); birth weight ≥ 90% for gestational age (OR 1.88, 95% CI 1.64-2.15); and increased risk of premature birth (OR 1.38, 95% CI 1.25-2.52) and neonatal asphyxia (OR 1.74, 95% CI 1.39-2.17). Maternal underweight increased the risk of low birth weight (OR 1.61, 95% CI 1.33-1.93) and small for gestational age (OR 1.75, 95% CI 1.51-2.02).
Raised as well as low pre-pregnancy BMI is associated with adverse neonatal outcomes. Management of weight during pregnancy might help reduce their adverse neonatal outcomes in future intervention studies or programmes.
母体体重指数与母婴短期和长期不良健康结局有关。我们进行了一项系统评价和荟萃分析，评估了中国基于人群的队列研究中母体 BMI 与不良新生儿结局的关系。
6 个数据库共确定了 2454 篇文章；其中 46 篇符合本研究的纳入标准。提取母体 BMI 和不良新生儿结局的二分类数据。汇总统计数据（比值比，OR）来自 Stata/SE，版本 12.0。敏感性分析评估了结果的稳健性。Meta 回归和亚组荟萃分析探讨了异质性。
荟萃分析显示，与正常 BMI 相比，高母体 BMI 与胎儿过度生长有关，定义为巨大儿（体重≥4000g）（OR 1.91，95%CI 1.75-2.09）；出生体重≥胎龄 90%（OR 1.88，95%CI 1.64-2.15）；早产（OR 1.38，95%CI 1.25-2.52）和新生儿窒息（OR 1.74，95%CI 1.39-2.17）的风险增加。母体体重不足增加了低出生体重（OR 1.61，95%CI 1.33-1.93）和小于胎龄儿（OR 1.75，95%CI 1.51-2.02）的风险。
孕前 BMI 升高和降低都与不良新生儿结局有关。在未来的干预研究或项目中，管理怀孕期间的体重可能有助于降低不良新生儿结局的风险。
