連続妊娠による体重変化と死産と乳児死亡のリスク:全国的なコホート研究

Sven Cnattingius¹, Eduardo Villamor²

¹Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.

Lancet (London, England)

|December 15, 2015

まとめ

妊娠間での母親の体重増加は死産と乳児死亡のリスクを高めます肥満の女性の健康的な体重と減量を促進することは妊娠の成果を向上させるのに不可欠です

科学分野:

生殖健康
妊婦と胎児の医療
公衆衛生

背景:

妊婦の過剰体重と肥満は死産と乳児死亡の既知の危険因子です
母親の体重の変化がこれらのリスクに与える影響は不明である.
この研究では,妊娠期間の体量指数 (BMI) の変化と,不良の生理周期のアウトカムとの関連が調査されています.

研究の目的:

第1次妊娠と第2次妊娠の間における母親の体量指数 (BMI) の変化が死産と乳児死亡のリスクに与える影響を評価する.
母親の体重管理のための根拠に基づいた勧告を提供すること.
生後リスクの増加に関連する特定のBMI変化のカテゴリーを特定する.

主な方法:

スウェーデンの集団ベースのコホート研究では,1992年から2012年の間に1人目と2人目の出産をした女性が含まれています.
母親のBMI変化と死産,新生児,新生児後の死亡,乳児死亡のリスクを分析した.
相対リスク (RRs) は,潜在的な混同因子を調整した二項回帰を用いて計算された.

主要な成果:

妊娠間少なくともBMI4単位増加した女性は,安定したBMIを持つ女性と比較して,死亡率 (RR1. 55) と乳児死亡率 (RR1.29) が著しく高かった.
死産のリスクは,より大きなBMI増加で線形増加を示した.
乳児死亡リスクは,当初健康なBMIを持つ女性のBMI増加に伴い,RRはそれぞれ1. 27と1. 60であった.
妊娠前の体重減少は,新生児死亡リスクの減少と関連していた.

結論:

妊娠前に体重増加を防ぐことは,健康な女性と肥満の女性にとって,死産と乳児死亡のリスクを軽減するために不可欠です.
妊娠前の肥満の女性の減量促進は,不良な周産結果を減らすために推奨されます.
妊婦の体重管理戦略は,妊娠間での体重変化を考慮する必要があります.

さらに関連する動画

05:04

A Common Marmoset Model of Mother-Infant Intervention for Breastfeeding Disorders in the Presence of Paternal Inhibition and Maternal Neglect

Published on: September 22, 2023

1.1K

06:55

Assessment of Maternal Vascular Remodeling During Pregnancy in the Mouse Uterus

Published on: December 5, 2015

14.3K

関連する概念動画

01:52

Regression Toward the Mean

7.3K

Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when...

7.3K

01:17

z Scores and Area Under the Curve

20.2K

z scores are the standardized values obtained after converting a normal distribution into a standard normal distribution. A z score is measured in units of the standard deviation. The z score tells you how many standard deviations the value x is above (to the right of) or below (to the left of) the mean, μ. Values of x that are larger than the mean have positive z scores, and values of x that are smaller than the mean have negative z scores. If x equals the mean, then x has a z score of...

20.2K

01:20

Pathophysiology of Diabetes

4.3K

Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...

4.3K

01:07

Teratogenicity

4.5K

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...

4.5K

01:28

Development of the Oral Microbiota

The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...

01:30

Development of Human Microbiota

The human microbiota begins developing at birth and undergoes continual change as we age. Infancy marks a critical period of microbial sensitivity, offering a “window of opportunity” during which beneficial microbes help mature the immune system. By age three, children typically develop a more stable and diverse microbial community. Newborns acquire microbes from their immediate environment; vaginal delivery favors maternal vaginal microbes, while cesarean births favor microbes from...

関連する実験動画