Department of Medical Sciences, University of Turin, CPO Piemonte, Turin, Italy.
Unit of Epidemiology, "Anna Meyer" Children's University Hospital, Florence, Italy.
Pediatr Obes. 2020 Aug;15(8):e12632. doi: 10.1111/ijpo.12632. Epub 2020 Mar 16.
BACKGROUND/OBJECTIVES: Several exposures during pregnancy are associated with offspring body mass index (BMI). The objective of this study was to evaluate whether third trimester antibiotic use and vaginal infections are associated with BMI in preschool children.
SUBJECTS/METHODS: The study population included singletons from the NINFEA birth cohort with available anthropometric measurements at the age of 4 (3151 born with vaginal and 1111 born with caesarean delivery). Self-reported use of antibiotics and the presence of vaginal infection in the third trimester were analysed in association with the child's BMI, classified into three categories: thinness, normal and overweight/obesity, using both the International Obesity Task Force (IOTF) and the World Health Organization (WHO) recommended cut-offs.
Maternal vaginal infections in the third trimester of pregnancy were associated with higher relative risk ratios (RRR) for overweight/obesity at age of four in children delivered vaginally: 1.92 (95% confidence interval [CI]: 1.37 to 2.70). This association appeared stronger for children born to women with pre-pregnancy BMI >25 kg/m (RRR: 4.78; 95% CI 2.45 to 9.35), and was robust when different obesity cut-offs were used. The results regarding third trimester antibiotic use in vaginal deliveries were less conclusive (RRRs for overweight/obesity: 1.43 (0.92 to 2.21) and 1.11 (0.57 to 2.20), for the IOTF and WHO cut-offs, respectively). Third trimester vaginal infections were not associated with BMI in children delivered by caesarean section.
Maternal third trimester vaginal infections are associated with an increased overweight/obesity risk in children born by vaginal delivery, and especially in children of mothers with pre-pregnancy overweight/obesity.
背景/目的：怀孕期间的几种暴露与后代的体重指数（BMI）有关。本研究的目的是评估妊娠晚期使用抗生素和阴道感染是否与学龄前儿童的 BMI 相关。
研究对象/方法：本研究人群包括 NINFEA 出生队列中的单胎婴儿，这些婴儿在 4 岁时有可获得的人体测量学数据（3151 名阴道分娩和 1111 名剖宫产）。分析了妊娠晚期自我报告的抗生素使用情况和阴道感染情况与儿童 BMI 的关系，BMI 分为消瘦、正常和超重/肥胖三个类别，使用国际肥胖工作组（IOTF）和世界卫生组织（WHO）推荐的切点进行分类。
妊娠晚期阴道感染与阴道分娩儿童 4 岁时超重/肥胖的相对风险比（RRR）相关：1.92（95%置信区间 [CI]：1.37 至 2.70）。对于孕前 BMI ＞25kg/m2 的女性所生的儿童，这种关联似乎更强（RRR：4.78；95% CI 2.45 至 9.35），并且当使用不同的肥胖切点时，结果仍然稳健。关于阴道分娩中妊娠晚期使用抗生素的结果则不太明确（超重/肥胖的 RRRs：IOTF 和 WHO 切点分别为 1.43（0.92 至 2.21）和 1.11（0.57 至 2.20））。妊娠晚期阴道感染与剖宫产分娩儿童的 BMI 无关。
母亲妊娠晚期阴道感染与阴道分娩的儿童超重/肥胖风险增加相关，尤其是在母亲孕前超重/肥胖的儿童中。
