辅助生育技术治疗后母体孕前体重指数与子痫前期的关系研究  

Relationship between maternal pre-pregnancy body mass index and pre-eclampsia after assisted reproductive technology treatment

作　　者：郭敏 张红真[2] 胡小娜 熊杰 GUO Min;ZHANG Hongzhen;HU Xiaona;XIONG Jie(Department of Obstetrics,Tangshan maternal and child health hospital,Tangshan 063000,China)

机构地区：[1]河北省唐山市妇幼保健院产科,063000 [2]河北医科大学第一医院妇产科 [3]唐山市妇幼保健院产房

出　　处：《中国煤炭工业医学杂志》2023年第6期598-602,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省2023年度医学科学研究课题计划(编号:20231747)。

摘　　要：目的探讨接受辅助生育技术(ART)治疗后母体孕前体重指数(BMI)对子痫前期(PE)发病风险的影响及其剂量-反应关系。方法以2020年9月—2022年8月于该院产科分娩并接受ART(体外受精-胚胎移植术及人工授精术)治疗的产妇为研究对象,选择其中诊断为子痫前期(PE)患者149例为PE组(病例组),未被诊断为PE的患者868例为非PE组(对照组)。通过电子病历信息系统,收集产妇的基本信息,包括年龄、孕前身高、孕前体重、产次、受教育程度、职业、家庭住址、分娩方式、临床诊断等。采用单因素分析及多因素Logistic回归模型,分析母体孕前BMI与PE之间的关系及二者之间的剂量-反应关系。结果共有1017名产妇符合标准纳入研究,56名(5.5%)女性孕前体重不足,288名(28.3%)女性超重,106名(10.4%)女性肥胖。单因素分析显示,PE组产妇孕前BMI高于非PE组(P<0.05),以孕前BMI正常组为参比,当BMI<18.5时,PE的危险性降低(P>0.05);当孕前BMI≥25时,PE的危险性随BMI的增长而升高(P<0.05),孕前BMI与PE危险度间存在剂量-反应关系(线性趋势P<0.05)。多因素Logistic回归分析显示,随着孕前BMI升高,PE的危险性增加,其中与正常BMI组比较,孕前BMI较低(BMI<18.5)的女性患PE的风险降低(OR=0.76,95%CI:0.26~2.25),而孕前超重(OR=1.67,95%CI:1.10~2.54,P<0.05)和肥胖(OR=2.99,95%CI:1.77~5.02)的女性患PE的风险显著增加(P<0.05)。结论接受ART治疗的产妇孕前BMI与PE有关联,母体孕前BMI与PE发病风险之间呈剂量-反应关系,孕前BMI越大,发生PE的危险性越高。这些发现支持了超重或肥胖女性在接受ART治疗前减肥的临床建议。Objective To explore the influence of maternal pre-pregnancy body mass index(BMI)on the risk of developing preeclampsia(PE)after assisted reproductive technology(ART)treatment,as well as the dose-response relationship between the two.Methods The study included women who gave birth and received ART treatment(including in vitro fertilization-embryo transfer and artificial insemination)in our hospital from September 2020 to August 2022.Among them,one hundred and forty-nine were diagnosed with PE(PE group,case group)and eight hundred and sixty-eight patients were not diagnosed with PE(non-PE group,control group).Basic information of the women,including age,pre-pregnancy height and weight,parity,education level,occupation,address,mode of delivery,and clinical diagnosis,was collected through an electronic medical record information system.The relationship between maternal pre-pregnancy BMI and PE,as well as the dose-response relationship between the two,was analyzed using univariate analysis and multiple logistic regression models.Results A total of one thousand and seventeen women met the inclusion criteria,of whom 56(5.5%)were underweight,288(28.3%)were overweight,and 106(10.4%)were obese.Univariate analysis showed that the maternal pre-pregnancy BMI in the PE group was higher than that in the non-PE group(P<0.05).When compared to the normal BMI group,the risk of PE was reduced when the BMI was<18.5(P>0.05).However,the risk of PE increased with increasing BMI when the pre-pregnancy BMI was≥25(P<0.05),indicating a dose-response relationship between pre-pregnancy BMI and the risk of PE(linear trend P<0.05).Multiple logistic regression analysis showed that as the pre-pregnancy BMI increased,the risk of PE also increased.Compared to the normal BMI group,women with lower pre-pregnancy BMI(<18.5)had a reduced risk of developing PE(OR=0.76,95%CI:0.26-2.25),while women who were overweight(OR=1.67,95%CI:1.10-2.54,P<0.05)and obese(OR=2.99,95%CI:1.77-5.02)before pregnancy had a significantly increased risk of developing PE(P<

关 键 词：子痫前期 孕前体重指数 辅助生育技术 剂量-反应分析 病例对照研究 

分 类 号：R714.2[医药卫生—妇产科学]