怀孕前的BMI和妊娠期间体重增加对早产的综合影响:自发和ART怀孕之间的比较
Shaoyan Lian1, Ying Huang1, Jieying Li1
1Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, Guangdong, China.
Journal of assisted reproduction and genetics
|January 26, 2024
概括
妊娠期体重增加 (GWG) 显著影响过早分娩 (PTB) 风险,超过怀孕前的体重指数 (BMI). 这对于辅助生殖技术 (ART) 怀孕至关重要,需要针对GWG的专注咨询以获得更好的结果.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 生殖医学 生殖医学
背景情况:
- 怀孕前的体重指数 (BMI) 和孕期体重增加 (GWG) 是早产 (PTB) 的已知风险因素.
- 怀孕前BMI与GWG对PTB风险的相对贡献尚不清楚.
- 这项研究调查了它们对PTB在自发和辅助生殖技术 (ART) 构想的单独怀孕中的综合作用.
研究的目的:
- 评估妊娠前BMI和GWG对早产风险的综合影响.
- 为了比较自发怀孕和通过ART怀孕之间的PTB风险.
- 为了确定哪个因素,怀孕前的BMI或GWG,在PTB中起着主导作用.
主要方法:
- 来自美国国家生命统计系统 (NVSS) 的大型数据集 (n=17,540,977) 对单生子活产 (2015-2019) 的分析.
- 使用后勤回归,量子-g计算和通用增量模型.
- 根据医学研究所 (IOM) 的指导方针,研究了怀孕前BMI类别和GWG之间的相互作用.
主要成果:
- 与非ART妊娠 (7.9%) 相比,辅助生殖技术 (ART) 怀孕的单独PTB比率 (11.5%) 更高.
- 在体重不足的非ART妇女和不充分的GWG和肥胖的ART妇女和不充分的GWG中观察到最高的PTB风险.
- 妊娠期体重增加 (GWG) 在增加PTB风险方面发挥了主导作用,这一点在非ART (-0.281) 和ART (-0.108) 组中都有显著的联合效应系数.
结论:
- 不适当的妊娠体重增加 (GWG) 是自发和ART怀孕中早产风险增加的主要驱动因素.
- 针对怀孕前的体重指数 (BMI) 和重要的是GWG的有针对性的咨询对所有怀孕至关重要.
- 这种咨询对于通过辅助生殖技术 (ART) 怀孕的怀孕尤其重要,因为它们的PTB风险概况较高.
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