Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, China.
Westlake Intelligent Biomarker Discovery Lab, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China.
Am J Clin Nutr. 2022 Aug 4;116(2):482-490. doi: 10.1093/ajcn/nqac127.
Postterm pregnancy has been associated with higher risk of perinatal mortality and morbidity, but its long-term health effects on offspring are poorly understood.
The aim of the study was to investigate the prospective associations between maternal postterm pregnancy and adverse growth outcomes in children.
The Jiaxing Birth Cohort is part of a large population-based health surveillance system in China and recruited pregnant females resident in the Jiaxing area between 1999 and 2013; newborns were followed up for a median duration of 5.8 y until they went to school. Mother-child pairs with maternal gestational information and offspring's anthropometric data at 4-7 y old were included. Postterm pregnancy was defined as maternal gestational age ≥42 and <47 wk, and its associations with offspring obesity, overweight/obesity, and thinness during childhood were determined by using Poisson regression models.
Of the 101,505 included mother-child pairs, 2369 (2.3%) children were born at postterm. Children born at postterm had significantly lower BMI-for-age z score, weight-for-age z score, and height-for-age z score than those born at term; the mean difference (95% CI) was -0.11 (-0.15, -0.06), -0.17 (-0.21, -0.13), and -0.16 (-0.20, -0.12), respectively. When comparing postterm with term pregnancy, the multivariable-adjusted RRs and 95% CIs among preschool-age children were 0.87 (0.68, 1.11) for obesity, 0.82 (0.72, 0.94) for overweight/obesity, and 1.18 (1.09, 1.28) for thinness, respectively. These risk estimates were robust in sensitivity analyses, but were attenuated in several subgroups stratified by age, sex, mode of delivery, and fetal distress.
Postterm pregnancy was associated with a higher risk of thinness, and a lower risk of overweight/obesity, as well as lower growth parameters in preschool-age children. These findings imply that postterm pregnancy may impede the long-term growth of offspring.
过期妊娠与围产期死亡率和发病率升高有关，但人们对其对后代的长期健康影响知之甚少。
本研究旨在探讨母亲过期妊娠与儿童不良生长结局的前瞻性关联。
嘉兴出生队列是中国一个大型基于人群的健康监测系统的一部分，于 1999 年至 2013 年期间招募居住在嘉兴地区的孕妇；对新生儿进行了中位数为 5.8 年的随访，直到他们上学。纳入了具有母婴妊娠信息和 4-7 岁儿童人体测量数据的母婴对。过期妊娠定义为母亲妊娠年龄≥42 周且＜47 周，并使用泊松回归模型确定过期妊娠与儿童期肥胖、超重/肥胖和消瘦的关系。
在纳入的 101505 对母婴中，有 2369 名（2.3%）儿童过期出生。过期出生的儿童的 BMI 年龄 z 评分、体重年龄 z 评分和身高年龄 z 评分均显著低于足月出生的儿童；平均值差异（95%CI）分别为-0.11（-0.15，-0.06）、-0.17（-0.21，-0.13）和-0.16（-0.20，-0.12）。与足月妊娠相比，学龄前儿童的多变量调整 RR 和 95%CI 分别为肥胖的 0.87（0.68，1.11）、超重/肥胖的 0.82（0.72，0.94）和消瘦的 1.18（1.09，1.28）。这些风险估计在敏感性分析中是稳健的，但在按年龄、性别、分娩方式和胎儿窘迫分层的几个亚组中有所减弱。
过期妊娠与学龄前儿童消瘦风险增加、超重/肥胖风险降低以及生长参数降低有关。这些发现表明，过期妊娠可能会阻碍后代的长期生长。
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