父母孕前体重指数对低出生体重发生的影响

Effects of parental pre-pregnancy body mass index on low birth weight

目的研究父母孕前体重指数(BMI)对新生儿低出生体重发生风险的影响,为新生儿低出生体重的预防提供科学依据。方法采用巢式病例对照研究方法,基于武汉出生队列项目选取2014-2018年从早孕期入组并接受长期随访的孕妇及其新生儿组成的母子对,按照病例对照纳入排除标准,并根据新生儿出生体重分为低出生体重组61对和正常出生体重对照组534对;通过问卷调查收集孕妇及其丈夫基本信息,产妇产检及住院分娩信息。采用Logistic回归模型分析孕妇及丈夫孕前BMI与低出生体重发生风险之间的相关性。结果低出生体重组孕前低BMI孕妇频率为36.07%,对照组孕前低BMI孕妇频率为20.22%;低出生体重组孕前正常BMI孕妇频率为57.38%,对照组孕前正常BMI孕妇频率为73.41%;低出生体重组孕妇孕前低BMI频率高于对照组,正常孕前BMI低于对照组,二者差异均有统计学意义(P<0.01)。丈夫低BMI和正常BMI频率在低出生体重组和对照组差异无统计学意义(P> 0.01)。结论孕妇孕前低BMI可致新生儿低出生体重发生风险显著增加,是低出生体重的高危因素之一;丈夫BMI对新生儿低出生体重发生影响不明显。孕妇孕前及孕期的体重管理对降低低出生体重发生有较大临床意义。

Objective To study the effect of the pre-pregnancy body mass index(BMI) of parents on the risk of neonatal low birth weight, and to provide scientific basis for the prevention of neonatal low birth weight.Methods This was a nested case-control study,based on the Wuhan Birth Cohort Project. The mother-child pairs of pregnant women and their newborns were selected, who entered the/exclusion criteria of case-control and birth weight, there were 61 pairs with the low birth weight newborn(low birth weight group)compared with 534 pairs as the normal birth weight(control group). The basic information of pregnant women and their husbands, and information of maternity check-up and in-patient delivery were collected by questionnaire. Logistic regression model was used to analyze the correlation between pre-pregnancy BMI of pregnant women and their husbands and low birth weight.Results The proportion of low pre-pregnancy BMI pregnant women in low birth weight group was 36.07%, compared with 20.22% in control group;the proportion of normal pre-pregnancy BMI pregnant women in low birth weight group was 57.38%, compared with 73.41% in control group. There were statistically significant differences in low and normal pre-pregnancy BMI pregnant women between the two groups(P< 0. 01).There were no difference in low and normal BMI of husbands betweenthe two groups(P> 0. 01).Conclusions Low pre-pregnancy BMI can can significantly increase the risk of neonatal low birth weight, which is one of the high-risk factors of low birth weight.However, pre-pregnancy BMI of husband has no significant effect on neonatal low birth weight. The weight management of pregnant women before and during pregnancy has great clinical significance to reduce the risk of low birth weight.