Su S F, Gao S, Zhang E J, Liu R X, Yue W T, Liu J H, Xie S H, Zhang Y, Yin C H
Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.
Department of Research Management, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2023 Jun 6;57(6):899-904. doi: 10.3760/cma.j.cn112150-20221008-00968.
To analyze the incidence of preterm birth based on pre-pregnancy body mass index (BMI) stratification and explore the associated factors of preterm birth among pregnant women at different BMI stratifications. From February 2018 to December 2020, pregnant women who participated in China Birth Cohort Study (CBCS) and gave birth at Beijing Obstetrics and Gynecology Hospital were enrolled as the study subjects. Electronic Data Capture System and standard structured questionnaires were used to collect data related to pre-pregnancy, pregnancy, and delivery for pregnant women. Pregnant women were divided into the low-weight group, normal-weight group and overweight group based on their pre-pregnancy BMI. A Cox proportional hazards model was used to analyze the associated factors of preterm birth among pregnant women with different BMI before pregnancy. A total of 27 195 singleton pregnant women were included, with a preterm birth rate of 5.08% (1 381/27 195). The preterm birth rates in the low-weight group, normal-weight group and overweight group were 4.29% (138/3 219), 4.63% (852/18 390) and 7.00% (391/5 586) respectively (<0.001). After adjusting for relevant factors, the Cox proportional hazards model showed that the risk of preterm birth in the overweight group was 1.457 times higher than that in the normal-weight group (95%: 1.292-1.643). Preeclampsia-eclampsia (=2.701, 95%: 1.318-5.537) was the associated factor for preterm birth in the low-weight group. Advanced maternal age (=1.232, 95%: 1.054-1.441), history of preterm birth (=4.647, 95%: 3.314-6.515), vaginal bleeding in early pregnancy (=1.613, 95%: 1.380-1.884), and preeclampsia-eclampsia (=3.553, 95%: 2.866-4.404) were associated factors for preterm birth in the normal-weight group. Advanced maternal age (=1.473, 95%: 1.193-1.818), history of preterm birth (=3.209, 95%: 1.960-5.253), vaginal bleeding in early pregnancy (=1.636, 95%: 1.301-2.058), preeclampsia-eclampsia (=2.873, 95%:2.265-3.643), and pre-gestational diabetes mellitus (=1.867, 95%: 1.283-2.717) were associated factors for preterm birth in the overweight group. Pre-pregnancy overweight is an associated factor for preterm birth, and there are significant differences in the associated factors of preterm birth among pregnant women with different BMI before pregnancy.
分析基于孕前体重指数（BMI）分层的早产发生率，并探讨不同BMI分层孕妇早产的相关因素。选取2018年2月至2020年12月参加中国出生队列研究（CBCS）并在北京妇产医院分娩的孕妇作为研究对象。采用电子数据采集系统和标准结构化问卷收集孕妇孕前、孕期及分娩相关数据。根据孕前BMI将孕妇分为低体重组、正常体重组和超重组。采用Cox比例风险模型分析孕前不同BMI孕妇早产的相关因素。共纳入27195名单胎孕妇，早产率为5.08%（1381/27195）。低体重组、正常体重组和超重组的早产率分别为4.29%（138/3219）、4.63%（852/18390）和7.00%（391/5586）（<0.001）。校正相关因素后，Cox比例风险模型显示，超重组早产风险比正常体重组高1.457倍（95%：1.292 - 1.643）。子痫前期 - 子痫（=2.701，95%：1.318 - 5.537）是低体重组早产的相关因素。高龄产妇（=1.232，95%：1.054 - 1.441）、早产史（=4.647，95%：3.314 - 6.515）、孕早期阴道出血（=1.613，95%：1.380 - 1.884）和子痫前期 - 子痫（=3.553，95%：2.866 - 4.404）是正常体重组早产的相关因素。高龄产妇（=1.473，9�%：1.193 - 1.818）、早产史（=3.209，95%：1.960 - 5.253）、孕早期阴道出血（=1.636，95%：1.301 - 2.058）、子痫前期 - 子痫（=2.873，95%：2.265 - 3.643）和孕前糖尿病（=1.867，95%：1.283 - 2.717）是超重组早产的相关因素。孕前超重是早产的相关因素，且孕前不同BMI孕妇早产的相关因素存在显著差异。
