Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
BMJ Open Diabetes Res Care. 2023 Apr;11(2). doi: 10.1136/bmjdrc-2023-003324.
To investigate the independent and combined effects of advanced maternal age and pre-pregnancy body mass index (BMI) on the risk of pre-eclampsia and gestational diabetes mellitus (GDM).
Logistic regression models were used to estimate the OR and 95% CIs of pre-eclampsia and GDM with advanced maternal age and pre-pregnancy BMI, respectively, and the interaction between advanced maternal age and pre-pregnancy BMI. We also used causal mediation analysis to assess the mediating role of pre-pregnancy BMI on maternal age-pre-eclampsia/GDM associations.
In this study, 788 cases (2.31%) were diagnosed with pre-eclampsia and 5430 cases (15.92%) were diagnosed with GDM. We found that advanced maternal age was associated with a higher risk for pre-eclampsia and GDM, with adjusted ORs (aORs) of 1.74 (95% CI 1.49-2.05) and 1.76 (95% CI 1.65-1.89) after adjusting for potential confounders, respectively. In addition, maternal pre-pregnancy overweight/obesity was associated with the risk of pre-eclampsia and GDM, with the corresponding aORs of 3.64 (95% CI 3.12-4.24) and 1.71 (95% CI 1.60-1.85), respectively. We also observed the interaction between maternal age and pre-pregnancy BMI for the risk of pre-eclampsia/GDM (all p for interaction <0.001). In the mediating effect analysis, we found that maternal pre-pregnancy BMI mediated the associations between maternal age and the development of pre-eclampsia and GDM.
Advanced maternal age and pre-pregnancy BMI were respectively associated with the risk of pre-eclampsia/GDM, and there was an interaction between the two risk factors. In addition, we found that pre-pregnancy BMI served as a mediator of the association between advanced maternal age and the risk of pre-eclampsia/GDM, providing an essential target for the prevention of maternal overweight/obesity.
研究高龄产妇和孕前体重指数（BMI）对先兆子痫和妊娠期糖尿病（GDM）风险的独立和联合影响。
使用逻辑回归模型分别估计高龄产妇和孕前 BMI 与先兆子痫和 GDM 的比值比（OR）和 95%置信区间（CI），以及高龄产妇和孕前 BMI 之间的交互作用。我们还使用因果中介分析来评估孕前 BMI 对母亲年龄与先兆子痫/GDM 关联的中介作用。
在这项研究中，788 例（2.31%）被诊断为先兆子痫，5430 例（15.92%）被诊断为 GDM。我们发现，高龄产妇与先兆子痫和 GDM 的风险增加有关，在调整了潜在混杂因素后，调整后的比值比（aOR）分别为 1.74（95%CI 1.49-2.05）和 1.76（95%CI 1.65-1.89）。此外，母亲孕前超重/肥胖与先兆子痫和 GDM 的风险相关，相应的 aOR 分别为 3.64（95%CI 3.12-4.24）和 1.71（95%CI 1.60-1.85）。我们还观察到母亲年龄和孕前 BMI 对先兆子痫/GDM 风险的交互作用（所有交互作用 p 值均<0.001）。在中介效应分析中，我们发现母亲孕前 BMI 介导了母亲年龄与先兆子痫和 GDM 发生之间的关联。
高龄产妇和孕前 BMI 分别与先兆子痫/GDM 的风险相关，并且这两个危险因素之间存在交互作用。此外，我们发现孕前 BMI 是高龄产妇与先兆子痫/GDM 风险关联的中介，为预防母亲超重/肥胖提供了一个重要目标。
