Liu Huiqiang, Wei Yanping, Zhang Wen, Meng Fei, Ding Nina, Liu Xicui
Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
Front Pediatr. 2025 Jun 19;13:1604845. doi: 10.3389/fped.2025.1604845. eCollection 2025.
Dynamic changes in maternal blood pressure influence neonatal birth weight however, studies investigating the association between blood pressure trajectories during pregnancy and low birth weight (LBW) remain limited. This study aims to identify maternal blood pressure trajectories based on three time points using group-based trajectory modeling (GBTM) and explore their association with LBW.
This study was based on the NHANES 2005-2006 database and included 330 pregnant women meeting the eligibility criteria (41 cases in the LBW group and 289 in the control group). GBTM was applied to model three blood pressure measurements [systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP)] taken during pregnancy. Multilevel logistic regression was used to assess the relationship between blood pressure trajectories and LBW. Additionally, stratified analyses were conducted to evaluate the modifying effects of age, body mass index (BMI), and education level, and directed acyclic graph (DAG) were employed for covariate selection.
Three distinct blood pressure trajectory patterns were identified. Logistic regression revealed that, compared with the low blood pressure trajectory, mothers with a high-medium SBP trajectory had a significantly increased risk of delivering an LBW infant [odds ratio [OR] = 4.479, 95% confidence interval [CI]: 2.541-7.895, < 0.001]. Stratified analyses indicated that this association was more pronounced in mothers who were older than 40 years, had a BMI >28, had lower income, did not consume alcohol, and had abnormal cholesterol levels. The DAG analysis further supported the independent effect of blood pressure trajectories on LBW.
Maternal blood pressure trajectories based on three prenatal measurements are closely associated with LBW, particularly among mothers with a high-medium SBP trajectory. This study underscores the importance of monitoring blood pressure fluctuations during pregnancy and suggests that early intervention may help reduce the risk of LBW.
母亲血压的动态变化会影响新生儿出生体重，然而，关于孕期血压轨迹与低出生体重（LBW）之间关联的研究仍然有限。本研究旨在使用基于群体的轨迹模型（GBTM），根据三个时间点确定母亲的血压轨迹，并探讨它们与低出生体重的关联。
本研究基于2005 - 2006年美国国家健康与营养检查调查（NHANES）数据库，纳入了330名符合入选标准的孕妇（低出生体重组41例，对照组289例）。应用GBTM对孕期测量的三项血压指标[收缩压（SBP）、舒张压（DBP）、脉压（PP）]进行建模。采用多水平逻辑回归评估血压轨迹与低出生体重之间的关系。此外，进行分层分析以评估年龄、体重指数（BMI）和教育水平的调节作用，并使用有向无环图（DAG）进行协变量选择。
识别出三种不同的血压轨迹模式。逻辑回归显示，与低血压轨迹相比，中高收缩压轨迹的母亲生出低出生体重婴儿的风险显著增加[比值比（OR）= 4.479，95%置信区间（CI）：2.541 - 7.895，P < 0.001]。分层分析表明，这种关联在年龄大于40岁、BMI > 28、收入较低、不饮酒且胆固醇水平异常的母亲中更为明显。DAG分析进一步支持了血压轨迹对低出生体重的独立影响。
基于孕期三次测量的母亲血压轨迹与低出生体重密切相关，特别是在中高收缩压轨迹的母亲中。本研究强调了孕期监测血压波动的重要性，并表明早期干预可能有助于降低低出生体重的风险。
