孕前体重指数及孕期增重对新生儿体重影响及其交互作用  

Effects and the interaction of pre-pregnancy body mass index and gestational weight gain on neonatal weight

作　　者：高稚[1] 杨兴华 GAO Zhi;YANG Xinghua(Information Centre of Xuan Wu Hospital,Capital Medical University Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院信息中心,北京100053 [2]首都医科大学公共卫生学院流行病与卫生统计学系,北京100049

出　　处：《中国生育健康杂志》2022年第3期222-227,共6页Chinese Journal of Reproductive Health

摘　　要：目的探讨产妇孕前体重指数及孕期增重对新生儿体重的影响。方法采用回顾性队列研究方法,收集北京某三甲医院2017—2021年4529例分娩产妇数据,根据孕前BMI及孕期增重分组,利用Logistic回归比较不同组别之间小于胎龄儿及大于胎龄儿的发生情况,并通过相乘、相加模型分析孕前体重指数及孕期增重对于新生儿体重影响是否存在交互作用。结果孕前体重偏低和孕期增重不足是发生小于胎龄儿的危险因素(OR=18.20,95%CI:13.65~24.26;OR=1.45,95%CI:1.07~1.97),孕前肥胖、孕期增重过多是发生大于胎龄儿的危险因素(OR=8.78,95%CI:6.84~11.28;OR=5.80,95%CI:4.44~7.58);孕前体重偏低和孕期增重不足对于发生小于胎龄儿相加模型有正向交互作用(RERI=14.62,95%CI:3.09~26.15,API=0.48,95%CI:0.26~0.70,SI=1.97,95%CI:1.27~3.07),孕前肥胖和孕期增重过多对于发生大于胎龄儿相加模型有正向交互作用(RERI=47.96,95%CI:22.40~73.52,API=0.65,95%CI:0.52~0.78,SI=2.93,95%CI:1.99~4.33)。结论孕前BMI和孕期增重均会影响新生儿体重,二者之间有交互作用。Objective To explore the effects of maternal body mass index before pregnancy and gestational weight gain on newborn weight.Methods A retrospective cohort study was conducted to collect the data of 4529 pregnant women in a third-class A hospital in Beijing from 2017 to 2021.According to pre-pregnancy BMI and gestational weight gain,logistic regression was used to compare the incidence of small-for-gestational-age(SGA)infants and large-for-gestational-age(LGA)infants among different groups.Multiplicative and additive interaction models were used to analyze the interaction between pre-pregnancy body mass index and pregnancy weight gain on newborn weight.Results Low body weight before pregnancy and insufficient GWG were risk factors for SGA(OR=18.20,95%CI:13.65-24.26;OR=1.45,95%CI:1.07-1.97),pre-pregnancy obesity and excessive GWG were risk factors for LGA(OR=8.78,95%CI:6.84-11.28;OR=5.80,95%CI:4.44-7.58);Low pre-pregnancy weight and insufficient GWG had a positive interaction with the SGA in additive model(RERI=14.62,95%CI:3.09-26.15;API=0.48,95%CI:0.26-0.70;SI=1.97,95%CI:1.27-3.07),obesity before pregnancy and excessive GWG had a positive interaction on the occurrence of the LGA in additive model(RERI=47.96,95%CI:22.40-73.52;API=0.65,95%CI:0.52-0.78;SI=2.93,95%CI:1.99-4.33).Conclusion Both pre-pregnancy BMI and GWG can affect newborn weight,and there is an interaction between them.

关 键 词：孕前体重指数 孕期增重 新生儿体重 小于胎龄儿 大于胎龄儿 

分 类 号：R17[医药卫生—妇幼卫生保健] R71[医药卫生—公共卫生与预防医学]