摘要
目的在队列研究基础之上应用中国妇女体质指数(BMI)标准研究孕前超重/肥胖的妇女与婴儿不良出生结局的关系。方法收集武汉市2011年6月—2013年6月76 709名孕妇的数据,应用logistic回归模型估计妇女孕前BMI和不良出生结局之间的关系。结果与正常体重妇女相比,消瘦妇女顺产的比例较高(OR=1.25, 95%CI=1.20～1.30),超重/肥胖妇女顺产的比例较低(OR=0.52,95%CI=0.48～0.56)。超重/肥胖妇女剖腹产较多(OR=1.94, 95%CI=1.80～2.08),消瘦妇女剖腹产较少(OR=0.80, 95%CI=0.77～0.83)。消瘦妇女阴道手术产比例较高(OR=1.33, 95%CI=1.02～1.73),超重和肥胖妇女阴道手术产较少(OR=0.56, 95%CI=0.32～0.96)。不同BMI组与Apgar评分(1 min)<7及Apgar评分(5 min)<7和新生儿窒息关联没有显著性意义。与正常体重妇女相比,超重/肥胖妇女孩子早产的比例较高(OR=1.29, 95%CI=1.14～1.46),消瘦妇女与早产也呈正相关(OR=1.37,95%CI=1.24～1.51)超重/肥胖妇女与生产巨大儿也有阳性相关(OR=2.36, 95%CI=2.15～2.59);消瘦妇女与生产巨大儿呈负相关(OR=0.51,95%CI=0.46～0.56)。不同BMI组与低出生体重的关联没有显著性差异。结论基于中国成人BMI标准,孕前超重/肥胖对顺产、剖宫产、早产及巨大儿都有显著影响。
Objective To examine the effect of pre-pregnancy body mass index(BMI) for Chinese women on adverse pregnant outcomes in Wuhan municipality, China. Methods We conducted a population-based cohort study in Wuhan,China among 76 709 pregnant women having singleton deliveries and their newborns during June 2011 to June2013. Logistic regression model was used to estimate associations of pre-pregnant BMI with adverse birth outcomes.Results Compared with the normal weight women, the lean women were more likely to have spontaneous vaginal delivery(odds ratio [OR] = 1.25, 95% confidence interval [95% CI]: 1.20-1.30);whereas the overweight/obese women were less likely to have spontaneous vaginal delivery(OR = 0.52, 95% Cl: 0.48-0.56);a significantly higher odd of cesarean section(OR = 1.94, 95% CI: 1.80-2.08) was noted among the overweight/obese women but a significantly lower odd of cesarean section(OR = 0.80, 95% CI: 0.77-0.83) was revealed among the lean women. In contrast to that among the normal weight women, the risk of operative vaginal delivery was significantly higher(OR = 1.33, 95% CI: 1.02-1.73) among the lean women but significantly lower among the overweight/obese women(OR = 0.56, 95% CI: 0.32-0.96). No significant associations of pre-pregnant BMI were found with Apgar score of less than 7 at one minute or at 5 minutes and with asphyxia neonatorum. In comparison wih the normal weight women, both the overweight/obese and lean women were significantly more likely to have preterm delivery(OR = 1.29, 95% CI: 1.14-1.46 and OR = 1.37, 95% CI: 1.24-1.51);the overweight/obese women were more likely(OR = 2.36, 95% CI: 2.15-2.59) but the lean women were less likely(OR =0.51, 95% CI: 0.46-0.56) to give a birth to a macrosomia. However, no significant association was observed between prepregnant BMI and low birth weight of the neonates. Conclusion Maternal pre-pregnancy overweight/obese has significant impact on the occurrence of spontaneous vaginal delivery, cesarean section, preterm delivery, and macrosomia based on the b
作者
彭安娜
张斌
李娜
袁丽芬
范丽
Lan Luong
杨少萍
PENG An-na;ZHANG Bin;LI Na(Affiliated Wuhan Children's Hospital-Wuhan Maternal and Child Healtheare Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei Province 430016,China)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2019年第2期162-166,共5页
Chinese Journal of Public Health
