Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
Obesity (Silver Spring). 2019 Jun;27(6):1030-1036. doi: 10.1002/oby.22478. Epub 2019 May 8.
This study aimed to examine the associations of maternal obesity in early pregnancy with adverse pregnancy outcomes.
A prospective cohort analysis was performed among 18,481 Chinese nulliparous women, using data from a 2006 to 2009 trial of prenatal micronutrient supplementation. Obesity was defined as BMI ≥ 27.5 kg/m . Interested outcomes included fetal loss (spontaneous abortion plus stillbirth), infant death, total mortality, and preterm and birth weight outcomes.
Compared with normal weight, obesity was associated with total mortality (adjusted relative risks [ARR] 1.34; 95% CI: 1.03-1.74) and fetal loss (ARR 1.51; 95% CI: 1.15-1.99) but not with infant death (ARR 0.53; 95% CI: 0.20-1.46). Further analyses showed that obesity was particularly associated with spontaneous abortion (ARR 1.51; 95% CI: 1.13-2.02) rather than stillbirth (ARR 1.52; 95% CI: 0.65-3.57). Moreover, obesity was associated with preterm birth (ARR 1.59; 95% CI: 1.25-2.02), macrosomia (ARR 3.71, 95% CI: 3.01-4.59), and large for gestational age (ARR 2.93; 95% CI: 2.49-3.47).
Maternal obesity in early pregnancy is associated with various adverse pregnancy outcomes in Chinese nulliparous women, suggesting the importance of an appropriate weight before and during pregnancy.
本研究旨在探讨早孕期母体肥胖与不良妊娠结局的关系。
采用 2006 年至 2009 年产前微量营养素补充试验的队列研究数据，对 18481 例中国初产妇进行前瞻性队列分析。肥胖定义为 BMI≥27.5kg/m 。感兴趣的结局包括胎儿丢失（自然流产加死胎）、婴儿死亡、总死亡率以及早产和出生体重结局。
与正常体重相比，肥胖与总死亡率（调整后的相对风险 [ARR]1.34；95%可信区间：1.03-1.74）和胎儿丢失（ARR 1.51；95%可信区间：1.15-1.99）相关，但与婴儿死亡（ARR 0.53；95%可信区间：0.20-1.46）无关。进一步分析表明，肥胖与自然流产（ARR 1.51；95%可信区间：1.13-2.02）而非死胎（ARR 1.52；95%可信区间：0.65-3.57）的关系更为密切。此外，肥胖与早产（ARR 1.59；95%可信区间：1.25-2.02）、巨大儿（ARR 3.71，95%可信区间：3.01-4.59）和大于胎龄儿（ARR 2.93；95%可信区间：2.49-3.47）有关。
早孕期母体肥胖与中国初产妇的各种不良妊娠结局有关，提示孕前和孕期保持适当体重的重要性。
