Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, Texas.
Department of Pharmaceutical Science, College of Pharmacy and Health Sciences, Texas Southern University, Houston, Texas.
Am J Perinatol. 2024 May;41(S 01):e2138-e2144. doi: 10.1055/a-2099-8494. Epub 2023 May 25.
The aim of this study was to examine the relationship between obesity and risk of stillbirth among pregnant women with obesity in the United States, with a focus on racial and ethnic disparities.
We conducted a retrospective cross-sectional analysis of birth and fetal data from the 2014 to 2019 National Vital Statistics System ( = 14,938,384 total births) to examine associations between maternal body mass index (BMI) and risk of stillbirth. Cox's proportional hazards regression model was used to compute adjusted hazard ratios (HR) as a measure of risk of stillbirth in relation to maternal BMI.
The stillbirth rate was 6.70 per 1,000 births among women with prepregnancy obesity, while the stillbirth rate among women with a normal (nonobese) prepregnancy BMI was 3.85 per 1,000 births. The risk of stillbirth was greater among women with obesity compared with women without obesity (HR: 1.39; 95% confidence interval [CI]: 1.37-1.41). Compared with non-Hispanic (NH) Whites, women identifying as NH-other (HR: 1.66; 95% CI: 1.61-1.72) and NH-Black (HR: 1.31; 95% CI: 1.26-1.35) were at higher risk of stillbirth, while Hispanic women had a decreased likelihood of stillbirth (HR: 0.38; 95% CI: 0.37-0.40).
Obesity is a modifiable risk factor for stillbirth. Public health awareness campaigns and strategies targeting weight management in women of reproductive age and racial/ethnic populations at highest risk for stillbirth, are needed.
· Stillbirth rates differ by race and ethnicity.. · Risk of stillbirth was greatest among women with obesity.. · Stillbirth rates rise with ascending prepregnancy BMI..
本研究旨在探讨美国肥胖孕妇肥胖与死胎风险之间的关系，重点关注种族和民族差异。
我们对 2014 年至 2019 年国家生命统计系统的生育和胎儿数据进行了回顾性横断面分析，以研究母体体重指数（BMI）与死胎风险之间的关系。使用 Cox 比例风险回归模型计算调整后的风险比（HR），作为与母体 BMI 相关的死胎风险的衡量标准。
在有孕前肥胖的女性中，死胎率为每 1000 例活产 6.70 例，而在有正常（非肥胖）孕前 BMI 的女性中，死胎率为每 1000 例活产 3.85 例。与非肥胖女性相比，肥胖女性的死胎风险更高（HR：1.39；95%置信区间[CI]：1.37-1.41）。与非西班牙裔（NH）白人相比，NH 其他族裔（HR：1.66；95%CI：1.61-1.72）和 NH 黑人（HR：1.31；95%CI：1.26-1.35）的死胎风险更高，而西班牙裔女性的死胎可能性较低（HR：0.38；95%CI：0.37-0.40）。
肥胖是死胎的一个可改变的危险因素。需要开展公共卫生宣传活动和战略，针对育龄妇女和死胎风险最高的种族/民族群体进行体重管理。
· 死胎率因种族和民族而异。· 肥胖孕妇的死胎风险最大。· 死胎率随孕前 BMI 的增加而上升。
