UTHealth School of Public Health, Department of Epidemiology, Human Genetics and Environmental Sciences, Houston, TX.
Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX.
Ann Epidemiol. 2020 Jan;41:21-27. doi: 10.1016/j.annepidem.2019.12.005. Epub 2019 Dec 13.
Maternal body mass index (BMI) is inversely associated with gastroschisis, but a causal relationship has not been established. As data demonstrating that a change in exposure status is related to a change in the frequency of the outcome can add to the evidence for causality, we conducted a case-control study of change in maternal BMI, assessed using interpregnancy change in BMI (IPC-BMI), and gastroschisis.
Data for 258 gastroschisis cases and 2561 controls were obtained from the Texas Birth Defects Registry and vital records (2006-2012). Logistic regression was used to estimate the adjusted association between IPC-BMI and gastroschisis.
The continuous IPC-BMI variable was inversely associated with gastroschisis (adjusted odds ratio [aOR] = 0.90, 95% confidence interval [CI]: 0.86, 0.95). When assessed as a six-level categorical variable, with weight stable women as the referent, the odds of gastroschisis were higher following a BMI decrease of greater than 1 unit (aOR = 1.37, 95% CI: 0.91, 2.06) and lower after a BMI increase of ≥3 units (aOR = 0.62, 95% CI: 0.42, 0.94).
Our findings suggest that maternal change in BMI is associated with gastroschisis and, thus, add to the epidemiological evidence that can be used to inform our understanding of the relationship between BMI and gastroschisis.
母体体重指数（BMI）与腹裂呈负相关，但尚未建立因果关系。由于表明暴露状况的变化与结果频率的变化相关的数据可以增加因果关系的证据，我们对母体 BMI 的变化（通过孕期 BMI 变化（IPC-BMI）进行评估）与腹裂进行了病例对照研究。
2006 年至 2012 年，从德克萨斯州出生缺陷登记处和生命记录中获取了 258 例腹裂病例和 2561 例对照的数据。使用逻辑回归来估计 IPC-BMI 与腹裂之间的调整关联。
连续的 IPC-BMI 变量与腹裂呈负相关（调整后的优势比[aOR] = 0.90，95%置信区间[CI]：0.86，0.95）。当作为六水平分类变量进行评估时，以体重稳定的女性为参照，BMI 下降大于 1 个单位时腹裂的几率较高（aOR = 1.37，95%CI：0.91，2.06），BMI 增加≥3 个单位时腹裂的几率较低（aOR = 0.62，95%CI：0.42，0.94）。
我们的研究结果表明，母体 BMI 的变化与腹裂有关，因此增加了可用于了解 BMI 与腹裂之间关系的流行病学证据。
