妊娠間での体重変化と不良妊娠結果のリスク:集団ベースの研究
Eduardo Villamor1, Sven Cnattingius
1Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. evillamo@hsph.harvard.edu
Lancet (London, England)
|October 3, 2006
まとめ
妊娠間での体重増加は,子宮内出血前症や妊娠糖尿病などの有害な結果のリスクを増大させます. 体重指数 (BMI) のわずかな増加でさえ,合併症を引き起こす可能性があり,妊娠前の体重管理の必要性を強調しています.
科学分野:
- 生殖伝染病学 生殖伝染病学
- 妊産婦と胎児の医学について
- 公衆衛生は公衆衛生である.
背景:
- 妊婦の肥満は不良な妊娠結果と関連しているが,因果的な証拠は限られている.
- 時間の体重変化を調査することで,母親の体重と妊娠リスクとの因果関係を明らかにすることができます.
研究 の 目的:
- 連続妊娠中の妊娠前体重指数 (BMI) の変化と,第二次妊娠における有害な結果のリスクとの関連を調べる.
- 妊娠を計画している女性のための体重管理の介入を支持する証拠を提供する.
主な方法:
- 全国規模のスウェーデン研究で,151,025人の女性が2回連続でシングルトン出産 (1992-2001) をした.
- 最初の妊娠から2番目の妊娠までの妊娠前のBMI変化の分析.
- 調整されたオッズ比率は,様々な不良妊娠結果のために計算されます.
主要な成果:
- 妊娠の間にBMI3単位以上を増加させると,妊娠前出血症 (1.78),妊娠期高血圧 (1.76),妊娠期糖尿病 (2.09),帝王切開 (1.32),死産 (1.63),妊娠年齢より大きめの出産 (1.87) のリスクが著しく高まります.
- アソシエーションは,体重変化の量と線形的な関係を示した.
- リスクは,当初健康なBMIを持っていた女性でも体重が増加した女性でも高かった.
結論:
- 発見は,過剰体重/肥満と不良な妊娠結果の間の因果関係を支持しています.
- 妊娠前の適度なBMI増加は,体重が増加することなくとも,胎内合併症を引き起こす可能性があります.
- 確固たる証拠は,肥満/肥満の女性の体重減少を推奨し,妊娠を計画している健康体重の女性の体重増加を防ぐことを支持しています.
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