父母的出生体重与足月产巨大儿风险：一项全国性人群研究。
Paternal and maternal birthweight and offspring risk of macrosomia at term gestations: A nationwide population study.
机构信息
Department of Clinical Science, Maternal-Fetal-Neonatal Research, University of Bergen, Bergen, Norway.
Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
出版信息
Paediatr Perinat Epidemiol. 2024 Mar;38(3):183-192. doi: 10.1111/ppe.13005. Epub 2023 Sep 2.
BACKGROUND
There is a paucity of data on whether parents' macrosomia (birthweight ≥4500 g) status influences the risk of macrosomia in the offspring. The role of maternal overweight in the generational effect of macrosomia is not known.
OBJECTIVE
To estimate the risk of macrosomia by parental birthweight at term and evaluate if this risk varied with maternal body mass index (BMI, kg/m) early in pregnancy.
METHODS
We used data from the Medical Birth Registry of Norway on all singleton term births (37-42 gestational weeks) during 1967-2017. The primary exposure was parental macrosomia, and the outcome was macrosomia in the second generation. The secondary exposure was maternal BMI. We used binomial regression to calculate relative risk (RR) with a 95% confidence interval. We assessed potential unmeasured confounding and selection bias using a probabilistic bias analysis and performed analyses with and without imputation for variables with missing values.
RESULTS
The data included 647,957 singleton parent-offspring trios born at term. The prevalence of macrosomia was 3.2% (n = 41,396) in the parental generation and 4.0% (n = 25,673) in the offspring generation. Macrosomia in parents was associated with an increased risk of macrosomia in offspring, with the RR for both parents were born macrosomic being 6.53 (95% confidence interval [CI] 5.31, 8.05), only mother macrosomic 3.37 (95% CI 3.17, 3.57) and only father macrosomic RR 2.22 (95% CI 2.12, 2.33). These risks increased by maternal BMI in early pregnancy: if both parents were born macrosomic, 17% of infants were macrosomic among mothers with normal BMI. If both parents were macrosomic and the mothers were obese, 31% of offspring were macrosomic. Macrosomia-related adverse outcomes did not differ with parental macrosomia status.
CONCLUSIONS
Parents' weight at birth and maternal BMI appear to be strongly associated with macrosomia in the offspring delivered at term gestations.
背景
关于父母巨大儿（出生体重≥4500 克）状态是否会影响后代巨大儿的风险，数据很少。母体超重在巨大儿代际效应中的作用尚不清楚。
目的
估计足月时父母出生体重导致巨大儿的风险，并评估该风险是否随孕早期母体体重指数（BMI，kg/m）变化而变化。
方法
我们使用挪威医学出生登记处的数据，该数据涵盖了 1967 年至 2017 年期间所有足月（37-42 孕周）的单胎分娩。主要暴露因素是父母巨大儿，而次要暴露因素是母亲 BMI。我们使用二项式回归计算相对风险（RR）及其 95%置信区间。我们使用概率偏差分析评估潜在的未测量混杂和选择偏差，并分别进行了有和无缺失值变量的校正分析。
结果
数据包括 647957 例足月单胎父母-子女三胞胎。在父母一代，巨大儿的患病率为 3.2%（n=41396），在后代一代，患病率为 4.0%（n=25673）。父母巨大儿与后代巨大儿风险增加相关，父母双方均为巨大儿的 RR 为 6.53（95%置信区间 [CI] 5.31, 8.05），仅母亲巨大儿 RR 为 3.37（95% CI 3.17, 3.57），仅父亲巨大儿 RR 为 2.22（95% CI 2.12, 2.33）。这些风险随孕早期母亲 BMI 增加而增加：如果父母双方均为巨大儿，正常 BMI 母亲中 17%的婴儿为巨大儿。如果父母双方均为巨大儿且母亲肥胖，31%的后代为巨大儿。与巨大儿相关的不良结局与父母巨大儿状态无差异。
结论
父母出生时的体重和母亲 BMI 似乎与足月分娩后代的巨大儿密切相关。
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