母亲孕前体质指数和孕期体重增加及其交互作用对新生儿出生体重的影响  

Association and interaction of pre-pregnant body mass index and gestational weight gain of women on neonatal birthweight

作　　者：林友结 蔡倩莹 徐云云 刘海燕[5] 韩文晖[6] 汪艳[6] 檀燕 熊海燕 胡安群[5] 郑英杰 Lin Youiie;Cai Qianying;Xu Yunyun;Liu Haiyan;Han Wenhui;Wang Yah;Tan Yan;Xiong Haiyan;Flu Anqun;Zheng Yingjie(Department of Public Health Microbiology;Department of Epidemiology;Key Laboratory for Public Health Safety, Ministry of Education , Key Laboratory for Health Technology Assessment, National Commission of Health and Family Planning;School of Public Health, Fudan University, Shanghai 200032, China;Department of Laboratory, 6.Department of Obstetrics and Gynecology, Anqing Municipal Hospital, Anqing 246003, China)

机构地区：[1]复旦大学公共卫生学院卫生微生物学教研室,上海200032 [2]复旦大学公共卫生学院流行病学教研室,上海200032 [3]复旦大学公共卫生学院公共卫生安全教育部重点实验室,上海200032 [4]复旦大学公共卫生学院国家卫生和计划生育委员会卫生技术评估重点实验室,上海200032 [5]安徽省安庆市立医院检验科,246003 [6]安徽省安庆市立医院妇产科,246003

出　　处：《中华流行病学杂志》2018年第6期770-775,共6页Chinese Journal of Epidemiology

基　　金：国家自然科学基金（81373065,81773490）;国家重点研发计划“生物安全关键技术研发”重点专项（2017YFC1200203）;上海市第四轮公共卫生体系建设三年行动计划重点学科项目（15GWZK0202）

摘　　要：目的 研究孕妇孕前BMI和孕期增重对新生儿出生体重的影响及其交互作用。方法 应用队列研究方法，选取2014年1月至2015年3月在安徽省安庆市立医院住院分娩的孕妇进行问卷调查，收集孕妇基本情况，并通过医院电子病历信息系统获取孕妇及新生儿信息。采用χ2检验、多分类logistic回归、相乘模型和相加模型分析孕妇孕前BMI、孕期增重及其交互作用与新生儿出生体重的关系。结果 共纳入单胎活产孕妇2 881例，其中小于胎龄儿359例（12.46%），大于胎龄儿273例（9.48%）。多分类logistic回归分析显示，控制可能的混杂因素后，孕前体重过低（aRR=1.33，95%CI：1.02-1.73）与孕期增重不足（aRR=1.64，95%CI：1.23-2.19）可增加小于胎龄儿发生风险，孕前超重/肥胖（aRR=1.86，95%CI：1.33-2.60）与孕期增重过多（aRR=2.03，95%CI：1.49-2.78）可增加大于胎龄儿发生风险；交互作用分析显示，未发现二者对新生儿出生体重存在交互作用。结论 母亲孕前体重和孕期增重与新生儿出生体重相关，但未发现二者之间的交互作用。Objective To investigate the association between maternal pre-pregnant body mass index and gestational weight gain, as well as their interaction on neonatal birthweight.Methods We built a cohort in Anqing Municipal Hospital from January 2014 to March 2015, enrolling pregnant women who decided to give birth in this hospital. All women were asked to fill a questionnaire for basic information collection. Medical information of both pregnant women and their newborns were obtained through electronic medical record. Chi-square analysis, multinomial logistic regression, multiplicative and additive interaction methods were used to analyze the association between pre-pregnant body mass index and gestational weight gain as well as their interactions on birth weight of the neonates.Results A total of 2 881 pregnant women were included in this study. Of the 2 881 newborns, 359 （12.46%） were small for gestational age （SGA） and 273 （9.48%） were large for gestational age （LGA）. After adjusting the possible confounding factors, results from the multinomial logistic regression showed that pre-pregnancy underweight women were more possible to deliver SGA （aRR=1.33, 95% CI：1.02-1.73）. If the gestational weight gain was below the recommended criteria, the risk of SGA （aRR=1.64, 95% CI：1.23-2.19） might increase. Pre-pregnancy overweight/obese could increase the risk of being LGA （aRR=1.86, 95% CI：1.33-2.60）. Maternal gestational weight gain above the recommendation level was associated with higher rates of LGA （aRR=2.03, 95% CI：1.49-2.78）.Results from the interaction analysis showed that there appeared no significant interaction between pre-pregnancy BMI and gestational weight on birthweight.Conclusion Pre-pregnancy body mass index and gestational weight gain were independently associated with neonatal birthweight while pre-pregnancy BMI and gestational weight gain did not present interaction on birthweight.

关 键 词：体质指数 孕期增重 小于胎龄儿 大于胎龄儿 交互作用 

分 类 号：R174[医药卫生—妇幼卫生保健]