波兰孕前体重指数和孕期体重增加对妊娠及新生儿结局的影响。
Effects of pre-pregnancy BMI and gestational weight gain on pregnancy and neonatal outcomes in Poland.
作者信息
Marchewka-Długońska Justyna, Nieczuja-Dwojacka Joanna, Krygowska Krystyna, Bogdanovich Veronika, Sys Dorota, Baranowska Barbara, Kobus Magdalena
机构信息
Institute of Biological Sciences, Faculty of Biology and Environmental Sciences, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland.
State University of Applied Sciences in Krosno, John Paul II Podkarpacie Regional Hospital, Krosno, Poland.
出版信息
Sci Rep. 2025 Mar 4;15(1):7603. doi: 10.1038/s41598-025-91879-z.
Overweight and obesity are significant public health concerns, affecting pregnant women and potentially leading to numerous complications for both maternal and neonatal health. The aim of this study is to estimate how pre-pregnancy overweight and obesity, as well as gestational weight gain, influence pregnancy outcomes and neonatal health in Poland. The study material consisted of data from 2878 women aged 16-46 years from hospitals in Warsaw and Krosno. The analysis included data on the course of singleton pregnancies and the biological condition of the newborns, correlated with pre-pregnancy Body Mass Index (BMI) and gestational weight gain (GWG), which were compared to the standards set by the Institute of Medicine (IOM). Factor that significantly influences pre-pregnancy BMI and GWG is the number of pregnancies. For first-born women pre-pregnancy BMI was significantly lower than that of women giving birth for the second, third and subsequent times (ANOVA p < 0.0001), at the same time, the increase in weight in this group was the greatest (ANOVA p < 0.0001). The study found that pre-pregnancy BMI correlates more strongly with the occurrence of gestational diabetes than GWG above IOM recommendations (regression: p < 0.0001, R = 0.112 vs. p < 0.0001, R = 0.104). Analogous correlations were observed for the incidence of gestational hypertension and termination of pregnancy by caesarean section. Birth weight and length are significantly affected by both pre-pregnancy BMI and GWG but the effect of weight change is stronger (birth weight - pre-pregnancy BMI regression p < 0.0001, R = 0.116; GWG p < 0.0001, R = 0.248; birth length - pre-pregnancy BMI regression p < 0.0001, R = 0.087; GWG p < 0.0001, R = 0.180). An analogous relationship was observed for the presence of macrosomia. For APGAR scores, an inverse relationship was observed; while GWG did not show a significant relationship with the first minute score, perinatal neonatal status was significantly related to the mother's pre-pregnancy BMI (regression p = 0.0006). Similarly, pre-pregnancy maternal BMI > 25 significantly increased the odds of perinatal injury and breastfeeding difficulties.
超重和肥胖是重大的公共卫生问题，影响着孕妇，并可能给孕产妇和新生儿健康带来诸多并发症。本研究的目的是评估孕前超重和肥胖以及孕期体重增加如何影响波兰的妊娠结局和新生儿健康。研究材料包括来自华沙和克罗斯诺医院的2878名年龄在16 - 46岁女性的数据。分析包括单胎妊娠过程和新生儿生物学状况的数据，这些数据与孕前体重指数（BMI）和孕期体重增加（GWG）相关，并与美国医学研究所（IOM）设定的标准进行比较。显著影响孕前BMI和GWG的因素是妊娠次数。对于初产妇，孕前BMI显著低于二胎、三胎及多胎产妇（方差分析p < 0.0001），同时，这组产妇的体重增加幅度最大（方差分析p < 0.0001）。研究发现，与高于IOM建议的GWG相比，孕前BMI与妊娠期糖尿病的发生相关性更强（回归分析：p < 0.0001，R = 0.112对比p < 0.0001，R = 0.104）。对于妊娠期高血压的发生率和剖宫产终止妊娠情况，也观察到类似的相关性。出生体重和身长均受到孕前BMI和GWG的显著影响，但体重变化的影响更强（出生体重 - 孕前BMI回归分析p < 0.0001，R = 0.116；GWG p < 0.0001，R = 0.248；出生身长 - 孕前BMI回归分析p < 0.0001，R = 0.087；GWG p < 0.0001，R = 0.180）。对于巨大儿的情况也观察到类似的关系。对于阿氏评分，观察到一种相反的关系；虽然GWG与一分钟评分没有显著关系，但围产期新生儿状况与母亲孕前BMI显著相关（回归分析p = 0.0006）。同样，孕前母亲BMI > 25显著增加了围产期损伤和母乳喂养困难的几率。
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