多样化妊娠队列中的妊娠体重变化和50年死亡率:前性观察队列研究
Stefanie N Hinkle1, Sunni L Mumford1, Katherine L Grantz2
1Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Lancet (London, England)
|October 22, 2023
概括
高孕期体重增加与长期死亡率增加有关,特别是与心血管和糖尿病相关的死亡,强调建议的孕期体重增加对持久健康结果的重要性.
科学领域:
- 产科和妇科
- 公共卫生
- 流行病学
背景情况:
- 高孕期体重增加与产后体重保持有关.
- 孕期体重变化的长期健康影响尚不清楚.
- 这项研究调查了50年后妊娠期体重变化与死亡率之间的联系.
研究的目的:
- 评估孕期体重变化与所有原因,心血管和糖尿病相关死亡率之间的长期关联.
- 在不同孕前体重指数 (BMI) 类别中检查这些关联.
- 提供支持健康妊娠体重增加建议的证据.
主要方法:
- 采用了来自美国怀孕队列协作周产期项目 (CPP) 的数据 (1959-1965年).
- 将CPP参与者与国家死亡指数和社会保障死亡总档联系起来,以获得至2016年的重要状态.
- 使用调整的危险比率 (HRs) 来估计妊娠体重增加/减轻和死亡率之间的关联,按妊娠前的BMI分层.
主要成果:
- 在46,042名参与者中,17901人 (38. 9%) 在中位数为52年的随访期间死亡.
- 在正常体重的个体中,过度妊娠体重增加与全因和心血管死亡率的增加有关,在超重个体中,全因和糖尿病相关的死亡率增加.
- 超出推值的体重增加与体重不足患者心血管死亡率的增加有关. 在正常体重的个体中,体重减轻低于推值与糖尿病相关死亡率的降低有关.
- 由于信任区间很大,在怀孕前肥胖的参与者中没有发现有意义的关联.
结论:
- 在推范围内的妊娠体重增加对长期健康至关重要.
- 偏离建议的妊娠体重增加,特别是过度体重增加,与几十年后心血管和糖尿病相关死亡风险的增加有关.
- 这些发现强调了孕妇体重管理对孕妇健康状况的持久影响.
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