Grant Imogen D, Giussani Dino A, Aiken Catherine E
University Department of Obstetrics and Gynaecology, University of Cambridge, NIHR Cambridge Biomedical Research Centre, Cambridge, UK.
Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK.
Int J Gynaecol Obstet. 2022 May;157(2):221-229. doi: 10.1002/ijgo.13779. Epub 2021 Jul 10.
To understand the relationship between birth weight and altitude to improve health outcomes in high-altitude populations, to systematically assess the impact of altitude on the likelihood of low birth weight (LBW), small for gestational age (SGA), and spontaneous preterm birth (sPTB), and to estimate the magnitude of reduced birth weight associated with altitude.
PubMed, OvidEMBASE, Cochrane Library, Medline, Web of Science, and clinicaltrials.gov were searched (from inception to November 11, 2020). Observational, cohort, or case-control studies were included if they reported a high altitude (>2500 m) and appropriate control population.
Of 2524 studies identified, 59 were included (n = 1 604 770 pregnancies). Data were abstracted according to PRISMA guidelines, and were pooled using random-effects models. There are greater odds of LBW (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.33-1.62, P < 0.001), SGA (OR 1.88, 95% CI 1.08-3.28, P = 0.026), and sPTB (OR 1.23, 95% CI 1.04-1.47, P = 0.016) in high- versus low-altitude pregnancies. Birth weight decreases by 54.7 g (±13.0 g, P < 0.0001) per 1000 m increase in altitude. Average gestational age at delivery was not significantly different.
Globally, the likelihood of adverse perinatal outcomes, including LBW, SGA, and sPTB, increases in high-altitude pregnancies. There is an inverse relationship between birth weight and altitude. These findings have important implications for the increasing global population living at altitudes above 2500 m.
了解出生体重与海拔之间的关系，以改善高海拔人群的健康结局，系统评估海拔对低出生体重（LBW）、小于胎龄儿（SGA）和自发性早产（sPTB）可能性的影响，并估计与海拔相关的出生体重降低幅度。
检索了PubMed、OvidEMBASE、Cochrane图书馆、Medline、Web of Science和clinicaltrials.gov（从创刊至2020年11月11日）。如果观察性、队列或病例对照研究报告了高海拔（>2500米）和适当的对照人群，则纳入研究。
在识别出的2524项研究中，纳入了59项（n = 1604770例妊娠）。根据PRISMA指南提取数据，并使用随机效应模型进行汇总。与低海拔妊娠相比，高海拔妊娠发生低出生体重（优势比[OR] 1.47，95%置信区间[CI] 1.33 - 1.62，P < 0.001）、小于胎龄儿（OR 1.88，95% CI 1.08 - 3.28，P = 0.026）和自发性早产（OR 1.23，95% CI 1.04 - 1.47，P = 0.016）的几率更高。海拔每升高1000米，出生体重下降54.7克（±13.0克，P < 0.0001）。平均分娩孕周无显著差异。
在全球范围内，高海拔妊娠中包括低出生体重、小于胎龄儿和自发性早产在内的不良围产期结局的可能性增加。出生体重与海拔呈负相关。这些发现对全球生活在海拔2500米以上地区不断增加的人口具有重要意义。
