Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan.
Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan.
PLoS One. 2024 Feb 29;19(2):e0299794. doi: 10.1371/journal.pone.0299794. eCollection 2024.
Previous studies have shown that interpregnancy weight fluctuations impact perinatal outcomes. In order to examine this in Japanese women, we analyzed the data of 2,861 women in their first and second pregnancies who delivered singletons between 2000 and 2022. We compared the second pregnancy perinatal outcomes of women whose interpregnancy body mass index (BMI) change was -1 to 1 unit with those of women whose BMI change was < -1 or ≥ 1 unit. An interpregnancy BMI change ≥ 1 unit was associated with an increased risk of developing gestational diabetes mellitus (adjusted odds ratio [aOR], 1.51; 95% confidence interval [CI], 1.18-1.95) and delivering a large for gestational age neonate (aOR, 1.67; 95% CI, 1.15-2.42) but a decreased risk of preterm birth (aOR, 0.66; 95% CI, 0.46-0.95). An interpregnancy BMI change < -1 unit was associated with a decreased risk of developing gestational diabetes mellitus (aOR, 0.51; 95% CI, 0.31-0.85). In a subgroup analysis of three groups divided according to prepregnancy BMI, interpregnancy BMI changes ≥ 1 unit in women with a BMI of < 18.5 kg/m2 before their first pregnancy were associated with a remarkable risk reduction of developing preterm birth (aOR, 0.30; 95% CI, 0.11-0.81). Interpregnancy BMI changes < -1 unit in women with a BMI of ≥ 25 kg/m2 before their first pregnancy were associated with a remarkable risk reduction of developing gestational diabetes mellitus (aOR, 0.33; 95% CI, 0.12-0.88). Weight gain during interpregnancy period was related to an increased risk of gestational diabetes mellitus and delivery of a large-for-gestational-age neonate, whereas weight loss was related to a decreased risk of developing gestational diabetes mellitus. These results indicate the importance of interpregnancy weight control as part of preconception care; therefore, women considering additional pregnancies should be educated on the importance of maintaining a healthy weight.
先前的研究表明，孕次间体重波动会影响围产期结局。为了在日本女性中检验这一点，我们分析了 2000 年至 2022 年间分娩单胎的 2861 名初产妇和经产妇的数据。我们比较了孕次间体重指数（BMI）变化为-1 至 1 单位的妇女与 BMI 变化< -1 或≥ 1 单位的妇女的第二孕期围产期结局。孕次间 BMI 变化≥ 1 单位与妊娠期糖尿病（调整后的优势比[aOR]，1.51；95%置信区间[CI]，1.18-1.95）和巨大儿（aOR，1.67；95%CI，1.15-2.42）的发生风险增加相关，但早产（aOR，0.66；95%CI，0.46-0.95）的风险降低。孕次间 BMI 变化< -1 单位与妊娠期糖尿病的发生风险降低相关（aOR，0.51；95%CI，0.31-0.85）。根据孕前 BMI 将人群分为三组进行亚组分析，在第一孕期前 BMI<18.5kg/m2 的女性中，孕次间 BMI 变化≥ 1 单位与早产风险显著降低相关（aOR，0.30；95%CI，0.11-0.81）。在第一孕期前 BMI≥25kg/m2 的女性中，孕次间 BMI 变化< -1 单位与妊娠期糖尿病的发生风险显著降低相关（aOR，0.33；95%CI，0.12-0.88）。孕次间体重增加与妊娠期糖尿病和巨大儿分娩的风险增加相关，而体重减轻与妊娠期糖尿病的发生风险降低相关。这些结果表明，在围孕期进行体重控制作为孕前保健的一部分非常重要；因此，应教育考虑再次妊娠的女性保持健康体重的重要性。
