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妊娠前の体量指数と重度の母性疾患との関連
Sarka Lisonkova1,2, Giulia M Muraca1,2, Jayson Potts3
1Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, Canada.
JAMA
|November 15, 2017
まとめ
妊娠前の体重指数 (BMI) の低さと高さは,母親の重症発症率や死亡率のわずかな増加と関連しています. この発見は,健康的なBMIを維持することの重要性を強調しています.
科学分野:
- 産婦人科
- 公衆衛生
- 流行病学について
背景:
- 体重指数 (BMI) が高いことは,出生に不利な結果をもたらす危険因子として認識されています.
- 妊娠前のBMIと重度の妊婦の死亡率との関連は不明である.
研究 の 目的:
- 妊娠前の体量指数 (BMI) と重度の母性疾患の発生率との関係を調査する.
主な方法:
- ワシントン州 (2004年−2013年) の出生証明書と入院データを用いて,人口を基に遡及的なコホート研究が行われました.
- 妊娠前のBMIは,体重不足,正常,体重過剰,肥満の3つのクラスに分類されました.
- ロジスティック回帰分析は,調整されたオッズ比率とレート差を計算するために使用され,母親の年齢やパリティなどの混同要因を制御しました.
主要な成果:
- この研究には74万3630人の独身児が含まれていた.
- 体重不足の女性は正常BMIの女性と比較して,調整された確率比 (OR) が1. 2 (95%CI,1. 0- 1. 3) であったが,クラス3の肥満の女性は重度の母性疾患または死亡率でORが1. 4 (95%CI,1. 3 - 1. 5) であった.
- 体重不足 (28. 8),体重過多 (17. 6),肥満クラス1 (24. 9),2 (35. 8),3 (61. 1) について,リスクの絶対的増加が観察されました.
結論:
- 体重不足と肥満の両方 (すべてのクラス) は,統計的に有意であるが,母親の重篤な罹病率や死亡率の絶対的な増加と関連しています.
- これらの発見は,妊婦の健康を最適化し,重症病変のリスクを減らすために,妊娠前のBMI管理の重要性を強調しています.
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