Mahomed K, Williams M A, Woelk G B, Jenkins-Woelk L, Mudzamiri S, Longstaff L, Sorensen T K
Department of Obstetrics and Gynaecology, University of Zimbabwe, School of Medicine, Harare, Zimbabwe.
Paediatr Perinat Epidemiol. 1998 Jul;12(3):253-62. doi: 10.1046/j.1365-3016.1998.00116.x.
Maternal pre-pregnancy obesity is a risk factor for pre-eclampsia (proteinuric hypertension in pregnancy) among North American and European women. We studied the relationship between maternal obesity and risk of pre-eclampsia among Zimbabwean women. A case-control study was conducted at Harare Maternity Hospital, Harare, Zimbabwe, between June 1995 and April 1996. Study participants were 144 women with pre-eclampsia and 194 normotensive women serving as controls. Maternal weight, height and mid-arm circumference were measured and recorded during study participants' postpartum hospital admission. Maternal mid-arm circumference, considered to be relatively stable during pregnancy among women of developing countries, was used as the primary indicator of maternal pre-pregnancy obesity. Logistic regression procedures were used to estimate odds ratios and 95% confidence intervals. There were linear trends in risk of pre-eclampsia with increasing mid-arm circumference, increasing weight and increasing body mass index. After adjusting for potential confounding factors, women in the highest quintile for mid-arm circumference (28-39 cm) were 4.4 times more likely to have had their pregnancy complicated by pre-eclampsia than women in the lowest quintile (21-23 cm). Odds ratios of similar magnitude were observed for the other anthropometric measures. To our knowledge, this is the first study to demonstrate a positive association between maternal obesity and pre-eclampsia risk in a black African population. Biological mechanisms thought to explain this relatively consistent epidemiological finding include endothelial cell injury, possibly resulting from hyperlipidaemia.
在北美和欧洲女性中，孕前肥胖是子痫前期（妊娠期蛋白尿性高血压）的一个风险因素。我们研究了津巴布韦女性中孕妇肥胖与子痫前期风险之间的关系。1995年6月至1996年4月期间，在津巴布韦哈拉雷的哈拉雷妇产医院进行了一项病例对照研究。研究参与者为144名患有子痫前期的女性和194名血压正常的女性作为对照。在研究参与者产后住院期间测量并记录其体重、身高和上臂中部周长。上臂中部周长在发展中国家女性孕期被认为相对稳定，被用作孕妇孕前肥胖的主要指标。采用逻辑回归程序来估计比值比和95%置信区间。子痫前期风险随着上臂中部周长增加、体重增加和体重指数增加呈线性趋势。在对潜在混杂因素进行调整后，上臂中部周长处于最高五分位数（28 - 39厘米）的女性发生子痫前期妊娠并发症的可能性是处于最低五分位数（21 - 23厘米）女性的4.4倍。其他人体测量指标也观察到了类似幅度的比值比。据我们所知，这是第一项在非洲黑人人群中证明孕妇肥胖与子痫前期风险之间存在正相关的研究。被认为可以解释这一相对一致的流行病学发现的生物学机制包括可能由高脂血症导致的内皮细胞损伤。
