PDF(1395 KB)
孕前双亲体重指数、母孕期体重增值及其交互作用对新生儿出生体重的影响
史晓薇, 岳婕, 吕敏, 王丽, 白娥, 帖利军
中国当代儿科杂志 ›› 2019, Vol. 21 ›› Issue (8) : 783-788.
PDF(1395 KB)
PDF(1395 KB)
孕前双亲体重指数、母孕期体重增值及其交互作用对新生儿出生体重的影响
Influence of pre-pregnancy parental body mass index, maternal weight gain during pregnancy, and their interaction on neonatal birth weight
目的 探讨孕前双亲体重指数（BMI）和母孕期体重增值及其交互作用对新生儿出生体重的影响。方法 选取2017年1月至2018年10月在西安交通大学第一附属医院做定期产检并足月单胎分娩的孕妇1 127例，收集其孕前BMI、孕期体重增值、孕前丈夫BMI、新生儿出生体重等信息，分析新生儿出生体重与孕前父母BMI和母亲孕期体重增值之间的相关性及两变量间的交互作用。结果 1 127例足月新生儿中，低出生体重检出25例（2.22%），巨大儿检出43例（3.82%）。低出生体重儿、正常体重儿、巨大儿三组双亲孕前BMI值、母亲孕期体重增值的比较差异均有统计学意义（P < 0.05）。新生儿出生体重与孕前双亲BMI值、母亲孕期体重增值呈低度正相关（r=0.097~0.322，P < 0.05）；母亲孕前低体重可增加低出生体重儿的发生风险（RR=4.17，95% CI：1.86~9.38）；母亲孕前超重/肥胖、孕期体重增值超标可增加巨大儿的发生风险（分别RR=3.59，95% CI：1.93~6.67；RR=3.21，95% CI：1.39~7.37）。未发现母亲孕前BMI与孕期体重增值对新生儿出生体重的交互作用。结论 孕前双亲BMI和母亲孕期体重增值与新生儿出生体重有关，而母亲孕前BMI和孕期体重增值之间无交互作用。
Objective To investigate the influence of pre-pregnancy parental body mass index (BMI), maternal weight gain during pregnancy, and their interaction on neonatal birth weight. Methods A total of 1 127 pregnant women who underwent regular prenatal examinations and full-term singleton delivery in the First Hospital of Xi'an Jiaotong University from January 2017 to October 2018 were enrolled. The data on their pre-pregnancy BMI, maternal weight gain during pregnancy, pre-pregnancy BMI of the husband, and neonatal birth weight were collected. The interaction between pre-pregnancy parental BMI and maternal weight gain during pregnancy was analyzed, and their correlation with neonatal birth weight was analyzed. Results Among the 1 127 full-term neonates, the detection rates of low birth weight neonates and macrosomia were 2.22% (25/1 127) and 3.82% (43/1 127) respectively. There were significant differences in pre-pregnancy parental BMI and maternal weight gain during pregnancy among the low birth weight, normal birth weight, and macrosomia groups (P < 0.05). Neonatal birth weight was positively correlated with pre-pregnancy parental BMI and maternal weight gain during pregnancy (r=0.097-0.322, P < 0.05). Low maternal weight before pregnancy increased the risk of low birth weight (RR=4.17, 95%CI:1.86-9.38), and maternal overweight/obesity before pregnancy (RR=3.59, 95%CI:1.93-6.67) and excessive weight gain during pregnancy (RR=3.21, 95%CI:1.39-7.37) increased the risk of macrosomia. No interaction between pre-pregnancy maternal BMI and maternal weight gain during pregnancy was observed. Conclusions Pre-pregnancy parental BMI and maternal weight gain during pregnancy are related to neonatal birth weight, and there is no interaction between pre-pregnancy maternal BMI and maternal weight gain during pregnancy.
Low birth weight / Macrosomia / Body mass index / Pregnancy / Neonate
[1] 张琼, 吴运芹, 庄严, 等. 超低和极低出生体重儿神经发育结局及影响因素分析[J]. 中国当代儿科杂志, 2016, 18(8):683-687.
[2] Gamboa Delgado EM, Rangel-Díaz YA, Gutiérrez-Gómez YY. Association between birth weight and cardiometabolic risk factors in children of Bucaramanga, Colombia[J]. Nutr Hosp, 2017, 34(5):1105-1111.
[3] Szabelska-Zakrzewska K, Durko A, Socha-Banasiak A, et al. Metabolic syndrome in overweight or obese children and adolescents based on own material Abstract Key words[J]. Dev Period Med, 2018, 22(4):351-357.
[4] 兰茜, 张琚, 张亦奇, 等. 成都市孕妇孕期增重对新生儿出生体重的影响[J]. 卫生研究, 2018, 47(6):900-905.
[5] Goldstein RF, Abell SK, Ranasinha S, et al. Gestational weight gain across continents and ethnicity:systematic review and meta-analysis of maternal and infant outcomes in more than one million women[J]. BMC Med, 2018, 16(1):153.
[6] Corsi DJ, Subramanian SV, Ackerson LK, et al. Is there a greater maternal than paternal influence on offspring adiposity in India?[J]. Arch Dis Child, 2015, 100(10):973-979.
[7] Gómez-López L, Van Hulst A, Barnett TA, et al. Does parental body mass index status modify the associations among birth weight, early growth and childhood adiposity?[J]. Paediatr Child Health, 2013, 18(2):e2-e9.
[8] 陈春明, 孔灵芝. 中国成人超重和肥胖症预防控制指南[M]. 北京:人民卫生出版社, 2006:4.
[9] Zhou A, Xiong C, Hu R, et al. Pre-pregnancy BMI, gestational weight gain, and the risk of hypertensive disorders of pregnancy:a cohort study in Wuhan, China[J]. PLoS One, 2015, 10(8):e0136291.
[10] 赵建萍, 黄文斌, 覃冰清, 等. 孕前体重指数及孕期体重增长与新生儿出生体重的关系[J]. 中国医药导报, 2018, 15(30):84-86.
[11] 李慧君, 李德君, 丁桂凤. 乌鲁木齐市孕妇体重状况与妊娠并发症及分娩结局的相关性分析[J]. 新疆医学, 2018, 48(8):871-873.
[12] Goldstein RF, Abell SK, Ranasinha S, et al. Association of gestational weight gain with maternal and infant outcomes:a systematic review and meta-analysis[J]. JAMA, 2017, 317(21):2207-2225.
[13] Lindsay KL, Brennan L, Rath A, et al. Gestational weight gain in obese pregnancy:impact on maternal and foetal metabolic parameters and birth weight[J]. J Obstet Gynaecol, 2018, 38(1):60-65.
[14] Zhou Z, Lin Q, Xu X, et al. Maternal high-fat diet impairs follicular development of offspring through intraovarian kisspeptin/GPR54 system[J]. Reprod Biol Endocrinol, 2019, 7(1):13.
[15] Zhao R, Xu L, Wu ML, et a1. Maternal pre-pregnancy body mass index, gestational weight gain influence birth weight[J]. Women Birth, 2018, 3l(1):e20-e25.
[16] Richardson BS, Ruttinger S, Brown HK, et al. Maternal body mass index impacts fetal-placental size at birth and umbilical cord oxygen values with implications for regulatory mechanisms[J]. Early Hum Dev, 2017, 112:42-47.
[17] Demerath EW, Choh AC, Czerwinski SA, et al. Genetic and environmental influences on infant weight and weight change:the Fels Longitudinal Study[J]. Am J Hum Biol, 2007, 19(5):692-702.
[18] Donkin I, Versteyhe S, Ingerslev LR, et al. Obesity and bariatric surgery drive epigenetic variation of spermatozoa in humans[J]. Cell Metab, 2016, 23(2):369-378.
[19] Roy SM, Chesi A, Mentch F, et al. Body mass index (BMI) trajectories in infancy differ by population ancestry and may presage disparities in early childhood obesity[J]. J Clin Endocrinol Metab, 2015, 100(4):1551-1560.
[20] 郭思玉. 父亲体重状态和儿童饮食行为对学龄前儿童体格发育影响的研究[D]. 武汉:华中科技大学, 2017.
[21] Mejia-Lancheros C, Mehegan J, Murrin CM, et al. Smoking habit from the paternal line and grand-child's overweight or obesity status in early childhood:prospective findings from the lifeways cross-generation cohort study[J]. Int J Obes (Lond), 2018, 42(11):1853-1870.
[22] Jenkins TG, Aston KI, James ER, et al. Sperm epigenetics in the study of male fertility, offspring health, and potential clinical applications[J]. Syst Biol Reprod Med, 2017, 63(2):69-76.
[23] Linabery AM, Nahhas RW, Johnson W, et al. Stronger influence of maternal than paternal obesity on infant and early childhood body mass index:the Fels Longitudinal Study[J]. Pediatr Obes, 2013, 8(3):159-169.
[24] Sørensen TIA, Ajslev TA, Ängquist L, et al. Comparison of associations of maternal peri-pregnancy and paternal anthropometrics with child anthropometrics from birth through age 7 y assessed in the Danish National Birth Cohort[J]. Am J Clin Nutr, 2016, 104(2):389-396.
[25] 林友结, 蔡倩莹, 徐云云, 等. 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[J]. 中华流行病学杂志, 2018, 39(6):770-775.
