Guo Yanfang, Miao Qun, Huang Tianhua, Fell Deshayne B, Muldoon Katherine, Wen Shi-Wu, Walker Mark C, Gaudet Laura M
Better Outcomes Registry & Network Ontario, Ottawa, ON, Canada.
Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
Int J Obes (Lond). 2020 Jul;44(7):1521-1530. doi: 10.1038/s41366-020-0543-5. Epub 2020 Feb 19.
To examine the racial differences in the population attributable fraction (PAF) of prepregnancy obesity and excessive gestational weight gain to large-for-gestational-age (LGA) neonates.
We conducted a population-based retrospective cohort study among all women who had prenatal screening and had a singleton live birth in a hospital (1 April 2016-31 March 2017) using data from Ontario birth registry in Canada. We used multivariable log-binomial regression models to estimate the PAF and 95% confidence interval (CI) of LGA neonates due to prepregnancy obesity and excessive gestational weight gain. All models were stratified by race (White, Asian, and Black).
Of the 74,402 eligible women, the prevalence of prepregnancy obesity, excessive gestational weight gain, and LGA neonate was 21.1%, 60.0%, and 11.3%, respectively, for Whites; 9.3%, 45.9%, and 5.4%, respectively, for Asians; and 28.6%, 52.4%, and 7.9%, respectively, for Blacks. The association of prepregnancy obesity was greater than that of excessive gestational weight gain on LGA for all racial groups. Excessive gestational weight gain contributed more than prepregnancy obesity in Whites (PAF 32.9%, 95% CI [30.3-35.5%] and 16.6%, 95% CI [15.3-17.9%], respectively, for excessive gestational weight gain and prepregnancy obesity) and in Asians (PAF 32.1%, 95% CI [27.2-36.7%] and 11.8%, 95% CI [9.5-14.1%], respectively, for excessive gestational weight gain and prepregnancy obesity). Prepregnancy obesity (PAF 22.8%, 95% CI [17.1-28.1%]) and excessive gestational weight gain (PAF 20.1%, 95% CI [4.7-33.0%]) contributed to LGA neonates almost the same in Blacks.
Excessive gestational weight gain contributed more to LGA neonates than prepregnancy obesity in Whites and Asians, while there was no difference between excessive gestational weight gain and prepregnancy obesity in their contributions to the LGA neonates in Blacks. The differences are mostly driven by the differential prevalence of the two risk factors across racial groups.
研究孕前肥胖和孕期体重过度增加对大于胎龄（LGA）新生儿的人群归因分数（PAF）的种族差异。
我们利用加拿大安大略省出生登记处的数据，对2016年4月1日至2017年3月31日期间在一家医院进行产前筛查并单胎活产的所有女性进行了一项基于人群的回顾性队列研究。我们使用多变量对数二项回归模型来估计由于孕前肥胖和孕期体重过度增加导致的LGA新生儿的PAF及95%置信区间（CI）。所有模型均按种族（白人、亚洲人和黑人）分层。
在74402名符合条件的女性中，白人的孕前肥胖、孕期体重过度增加和LGA新生儿的患病率分别为21.1%、60.0%和11.3%；亚洲人分别为9.3%、45.9%和5.4%；黑人分别为28.6%、52.4%和7.9%。在所有种族群体中，孕前肥胖与LGA新生儿的关联大于孕期体重过度增加与LGA新生儿的关联。孕期体重过度增加对白人（孕期体重过度增加和孕前肥胖的PAF分别为32.9%，95%CI[30.3 - 35.5%]和16.6%，95%CI[15.3 - 17.9%]）和亚洲人（孕期体重过度增加和孕前肥胖的PAF分别为32.1%，95%CI[27.2 - 36.7%]和11.8%，95%CI[9.5 - 14.1%]）的LGA新生儿的贡献大于孕前肥胖。孕前肥胖（PAF 22.8%，95%CI[17.1 - 28.1%]）和孕期体重过度增加（PAF 20.1%，95%CI[4.7 - 33.0%]）对黑人LGA新生儿的贡献几乎相同。
在白人和亚洲人中，孕期体重过度增加对LGA新生儿的贡献大于孕前肥胖，而在黑人中，孕期体重过度增加和孕前肥胖对LGA新生儿的贡献没有差异。这些差异主要是由两个危险因素在不同种族群体中的不同患病率驱动的。
