Mubarik Sumaira, Nabi Ghulam, Wang Suqing, Fan Cuifang
Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, Hubei, China.
Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, Hubei, China.
Iran J Public Health. 2020 Sep;49(9):1727-1733. doi: 10.18502/ijph.v49i9.4092.
Advanced maternal age (AMA) is considered a risk factor associated with preeclampsia and adverse pregnancy outcomes. We aimed to assess the mediating role of preeclampsia between AMA and adverse pregnancy outcomes.
A sample of 14646 pregnant women from the tertiary hospital of Hubei Province, China, during the years 2011-2017 were included in this study. Pregnant women were divided into 4 groups according to their age at delivery. Mediated effect of preeclampsia with relation to AMA and adverse pregnancy outcomes was measured using structural equation modeling.
Women in the highest age group were significantly associated with preterm delivery [RR 1.37 (95% CI 1.24 - 1.49)] and low birth weight [RR 1.28 (95% CI 1.11 - 1.45)] compared with women in the lowest age group. The indirect effect (mediated effect) of AMA on preterm delivery and low birth weight mediated by preeclampsia was [β 0.053 (95% CI: 0.047, 0.060)], and [β 0.045 (95% CI: 0.038, 0.052)], respectively. The estimated mediation proportion of the effect of AMA due to mediated effect of preeclampsia was (35.5%) for pre-term delivery and (23.5%) for low birth weight.
Preeclampsia partially mediates the association between AMA and adverse pregnancy outcomes.
高龄孕产妇（AMA）被认为是与子痫前期及不良妊娠结局相关的一个风险因素。我们旨在评估子痫前期在高龄孕产妇与不良妊娠结局之间的中介作用。
本研究纳入了2011年至2017年间来自中国湖北省一家三级医院的14646名孕妇样本。孕妇根据分娩时的年龄分为4组。使用结构方程模型测量子痫前期与高龄孕产妇及不良妊娠结局相关的中介效应。
与年龄最小组的女性相比，年龄最大组的女性与早产[风险比1.37（95%置信区间1.24 - 1.49）]和低出生体重[风险比1.28（95%置信区间1.11 - 1.45）]显著相关。子痫前期介导的高龄孕产妇对早产和低出生体重的间接效应（中介效应）分别为[β0.053（95%置信区间：0.047，0.060）]和[β0.045（95%置信区间：0.038，0.052）]。子痫前期介导效应导致的高龄孕产妇效应的估计中介比例，早产为（35.5%），低出生体重为（23.5%）。
子痫前期部分介导了高龄孕产妇与不良妊娠结局之间的关联。
