怀孕期间体重变化和不良妊娠结果的风险:基于人口的研究
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
概括
怀孕期间体重增加增加了诸如子前期和妊娠期糖尿病等不良结果的风险. 即使是适度的体重指数 (BMI) 增加也可能导致并发症,这凸显了怀孕前需要进行体重管理的必要性.
科学领域:
- 生殖流行病学 生殖流行病学
- 孕产妇和胎儿的医学
- 公共卫生 公共卫生
背景情况:
- 孕产妇肥胖与不良妊娠结果有关,但因果证据有限.
- 调查时间体重变化可以澄清母亲体重和怀孕风险之间的因果关系.
研究的目的:
- 检查连续怀孕期间怀孕前体重指数 (BMI) 变化与第二次怀孕中不良结果风险之间的关联.
- 为计划怀孕的妇女提供支持体重管理干预措施的证据.
主要方法:
- 在瑞典全国范围内对151,025名连续两次单子分娩的妇女进行了研究 (1992-2001).
- 从第一个怀孕到第二个怀孕,怀孕前的BMI变化分析.
- 为各种不良妊娠结果计算的调整后的几率比率.
主要成果:
- 在怀孕之间获得3个以上的BMI单位显著增加了风险:妊娠前 (1.78),妊娠高血压 (1.76),妊娠糖尿病 (2.09),剖腹产 (1.32),死产 (1.63),以及大于妊娠年龄的出生 (1.87).
- 关联表明与体重变化的数量有线关系.
- 即使在最初健康的BMI的女性中,体重增加的风险也会增加.
结论:
- 这些发现支持超重/肥胖和不良妊娠结果之间的因果关系.
- 在怀孕前适度的BMI增加可能会导致产周并发症,即使没有超重.
- 强有力的证据支持倡导超重/肥胖女性减肥,并防止计划怀孕的健康体重女性体重增加.
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