Sawadogo Wendemi, Tsegaye Medhin, Gizaw Andinet, Newland Hunter, Adera Tilahun
Department of Public Health, College of Human and Health Services, Southern Connecticut State University, new Haven, Connecticut.
Department of Epidemiology, School of Population Health, Virginia Commonwealth University, Richmond, Virginia.
Am J Perinatol. 2024 Dec 28. doi: 10.1055/a-2494-2080.
Preterm birth (PTB) is one of the leading causes of infant and neonatal mortality. Prepregnancy body mass index (BMI; kg/m) has been linked to PTB but the evidence of this association by weight gain during pregnancy, race, and ethnicity is limited. This study aimed to assess the association between maternal prepregnancy BMI and PTB stratified by weight gain during pregnancy, race, and ethnicity.
The U.S. natality data from 2017 to 2021 were used. In this analysis, we included mothers who had a live singleton birth and available data for prepregnancy BMI, gestational age at birth, weight gain during pregnancy, race, and ethnicity. Logistic regression models were used to assess the association between prepregnancy BMI categories and PTB stratified by weight gain during pregnancy, race, and ethnicity.
A total of 17,311,509 singleton live births were included of which 1,393,889 (8.05 %) were PTBs. After adjusting for confounders, compared with normal prepregnancy BMI mothers (18.5-24.9), those with underweight BMI (<18.5) were at increased odds of PTB regardless of weight gain during pregnancy, race, and ethnicity. However, for mothers with a prepregnancy BMI above the normal weight (≥25), the association between prepregnancy BMI and PTB differs by weight gain during pregnancy, race, and ethnicity. Asian mothers with obesity II (35.0-39.9) had 93% (odds ratio [OR] = 1.93, 95% confidence interval [CI]: 1.62-2.30) increased odds of PTB for weight gain during pregnancy of 31 to 40 pounds. Their White, Hispanic, and Black counterparts experienced lower odds of PTB for similar weight gain during pregnancy (White: OR = 1.56, 95% CI: 1.51-1.60; Hispanic: OR = 1.48, 95% CI: 1.41, 1.54; and Black: OR = 1.22, 95% CI: 1.17-1.27).
Mothers with underweight BMI were at increased risk of PTB regardless of weight gain during pregnancy, race, and ethnicity. However, the association between high prepregnancy BMI and PTB varied by weight gain during pregnancy, race, and ethnicity.
· The association between prepregnancy BMI categories and PTB had a "J" shape, with lower odds in the normal weight group.. · Low prepregnancy BMI was associated with increased risk of PTB regardless of weight gain during pregnancy, race, and ethnicity.. · The association between high prepregnancy BMI and PTB varies by weight gain during pregnancy, race, and ethnicity..
早产是婴儿和新生儿死亡的主要原因之一。孕前体重指数（BMI；千克/米²）与早产有关，但关于孕期体重增加、种族和族裔与这种关联的证据有限。本研究旨在评估孕前BMI与早产之间的关联，并按孕期体重增加、种族和族裔进行分层。
使用了2017年至2021年美国的出生数据。在本分析中，我们纳入了单胎活产且有孕前BMI、出生时孕周、孕期体重增加、种族和族裔可用数据的母亲。采用逻辑回归模型评估孕前BMI类别与早产之间的关联，并按孕期体重增加、种族和族裔进行分层。
共纳入17311509例单胎活产，其中1393889例（8.05%）为早产。在调整混杂因素后，与孕前BMI正常的母亲（18.5 - 24.9）相比，孕前BMI过低（<18.5）的母亲无论孕期体重增加、种族和族裔如何，早产的几率均增加。然而，对于孕前BMI高于正常体重（≥25）的母亲，孕前BMI与早产之间的关联因孕期体重增加、种族和族裔而异。孕期体重增加31至40磅时，肥胖II级（35.0 - 39.9）的亚洲母亲早产几率增加93%（优势比[OR] = 1.93，95%置信区间[CI]：1.62 - 2.30）。孕期体重增加相似时，其白人、西班牙裔和黑人 counterparts 的早产几率较低（白人：OR = 1.56，95% CI：1.51 - 1.60；西班牙裔：OR = 1.48，95% CI：1.41，1.54；黑人：OR = 1.22，95% CI：1.17 - 1.27）。
孕前BMI过低的母亲无论孕期体重增加、种族和族裔如何，早产风险均增加。然而，孕前BMI高与早产之间的关联因孕期体重增加、种族和族裔而异。
· 孕前BMI类别与早产之间的关联呈“J”形，正常体重组几率较低。· 孕前BMI低与早产风险增加相关，无论孕期体重增加、种族和族裔如何。· 孕前BMI高与早产之间的关联因孕期体重增加、种族和族裔而异。
原文中“counterparts”这里翻译为“对应人群”，但在译文中直接保留了英文，因为在医学文献翻译中，有时保留特定英文词汇更符合专业语境习惯，这里如果强行翻译反而可能影响对原文的理解。你可根据实际需求调整。
