임신 전 체질량지수와 사산, 조산 및 저출생제중아 출산 위험
Prepregnancy Body Mass Index and the Risk of Stillbirth, Preterm Birth, and Low Birth Weight
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Objective: To explore whether women with overweight or underweight before pregnancy would be at higher risk of adverse birth outcomes. Methods: A retrospective study was conducted on 41,975 mothers who received health examination in 1997, and delivered a singleton live baby in 1999 or a singleton stillbirth from 1999 to 2000. Odds ratio (OR) and 95% confidence interval (CI) for stillbirth, preterm birth, and low birth weight (LBW) according to pre-pregnancy body mass index (BMI, kg/m2) by 3 or 7 groups, were adjusted for maternal age at delivery, socio-economic status, diabetes and parity using logistic regression model. Results: The adjusted ORs for preterm birth and LBW were 1.39 (95% CI 1.09~1.79), and 1.38 (95% CI 1.05~1.81) in overweight (BMI≥25) women compared to normal weight women (BMI 18.5~24.9), and 2.37 (95% CI 1.60~3.52) and 1.56 (95% CI 0.94~2.59) in obese (BMI≥27.5) women compared to women with middle normal weight (BMI 21~ 22.9), respectively. Obese women had a increased risk on very LBW (OR 6.2, 95% CI 1.99~19.3) compared to middle normal weight women. Moderately to severely thin women (BMI<17) also had a increased risk on LBW (OR 1.65, 95% CI 1.21~2.24) and moderately LBW (OR 1.72, 95% CI 1.26~2.35) compared to middle normal weight women. Conclusion: Overweight, especially obese women were at higher risk on preterm birth including moderately preterm birth, and very LBW. Moderately thin women also had a increased risk on LBW including moderately LBW. It may be beneficial for women with overweight and moderate to severe thinness to have desirable birth outcomes by weight control such as physical activity and diet control.
Abstract
Objective: To explore whether women with overweight or underweight before pregnancy would be at higher risk of adverse birth outcomes. Methods: A retrospective study was conducted on 41,975 mothers who received health examination in 1997, and delivered a singleton live baby in 1999 or a singleton stillbirth from 1999 to 2000. Odds ratio (OR) and 95% confidence interval (CI) for stillbirth, preterm birth, and low birth weight (LBW) according to pre-pregnancy body mass index (BMI, kg/m2) by 3 or 7 groups, were adjusted for maternal age at delivery, socio-economic status, diabetes and parity using logistic regression model. Results: The adjusted ORs for preterm birth and LBW were 1.39 (95% CI 1.09~1.79), and 1.38 (95% CI 1.05~1.81) in overweight (BMI≥25) women compared to normal weight women (BMI 18.5~24.9), and 2.37 (95% CI 1.60~3.52) and 1.56 (95% CI 0.94~2.59) in obese (BMI≥27.5) women compared to women with middle normal weight (BMI 21~ 22.9), respectively. Obese women had a increased risk on very LBW (OR 6.2, 95% CI 1.99~19.3) compared to middle normal weight women. Moderately to severely thin women (BMI<17) also had a increased risk on LBW (OR 1.65, 95% CI 1.21~2.24) and moderately LBW (OR 1.72, 95% CI 1.26~2.35) compared to middle normal weight women. Conclusion: Overweight, especially obese women were at higher risk on preterm birth including moderately preterm birth, and very LBW. Moderately thin women also had a increased risk on LBW including moderately LBW. It may be beneficial for women with overweight and moderate to severe thinness to have desirable birth outcomes by weight control such as physical activity and diet control.
참고문헌 (38)
- 1998年度 國民健康 營養調査 保健意識行態調査(20歲 以上 成人), "김혜련", 한국보건사회연구원, 51~64 (1999)
- "문보라, 요가 다이어트 3주만에 45kg "너무 뺐나?" (2010)[URL]
- 2009 국민건강통계 : 국민건강영양조사 제4기 3차년도 (2009), "질병관리본부", 보건복지부, ~ (2010)
- "거식증ㆍ폭식증 환자 10명 중 4명은 20~ 30대 여성" (2011)[URL]
- 1999년도 영아사망 보고서: 1999년도 영아사망 및 주산기사망의 수준과 원인분석, "한영자", 보건복지부, 82~89 (2002)
- '99年度 嬰兒‧母性死亡 調査를 위한 調査票 設計' 保健福地部, "한영자", 韓國保健社會硏究院, 58~61 (2001)
- Adams MM, "Risk factors for preterm delivery in a healthy cohort", Epidemiology, 6, pp.525~532 (1995)
- Ancel PY, "Very and moderate preterm births: are the risk factors different?", Br J Obstet Gynaecol, 106, pp.1162~1170 (1999)
- Baeten JM, "Pregnancy complications and outcomes among overweight and obese nulliparous women", Am J Public Health, 91, pp.436~440 (2001)
- Bhattacharya S, "Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies", BMC Public Health, 7, pp.168~ (2007)
- Bianco AT, "Pregnancy outcome and weight gain recommendations for the morbidly obese woman", Obstet Gynecol, 91, pp.97~102 (1998)
- Caballero B, "The global epidemic of obesity: an overview", Epidemiol Rev, 29, pp.1~5 (2007)
- Cedergren MI, "Maternal morbid obesity and the risk of adverse pregnancy outcome", Obstet Gynecol, 103(2), pp.219~224 (2004)
- Cnattingius S, "Prepregnancy weight and the risk of adverse pregnancy outcomes", N Engl JMed, 338, pp.147~152 (1998)
- Cogswell ME, "Gestational weight gain among average-weight and overweight women? what is excessive?", Am J Obstet Gynecol, 172, pp.705~712 (1995)
- Dietz PM, "Combined effects of prepregnancy bodymass index and weight gain during pregnancy on the risk of preterm delivery", Epidemiology, 17, pp.170~177 (2006)
- Driul L, "Prepregnancy body mass index and adverse pregnancy outcomes", Arch Gynecol Obstet, 278, pp.23~26 (2008)
- Frederick IO, "Prepregnancy body mass index, gestational weight gain, and other maternal characteristics in relation to infant birth weight", Matern Child Health J, 12, pp.557~567 (2008)
- Gorber SC, "A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review", Obes Rev, 8(4), pp.307~326 (2007)
- Han Z, "Knowledge Synthesis Group. Maternal underweight and the risk of preterm birth and low birth weight: a systematic review and meta-analyses", Int J Epidemiol, 40, pp.65~101 (2011)
- Hauger MS, "Prepregnancy weight status and the risk of adverse pregnancy outcome", Acta Obstet Gynecol Scand, 87, pp.953~959 (2008)
- Hulsey TC, "Maternal prepregnant body mass index and weight gain related to low birth weight in South Carolina", South Med J, 98, pp.411~415 (2005)
- Kim YJ, "Risk factors for preterm birth in Korea: a multicenter prospective study", Gynecol Obstet Invest, 60, pp.206~212 (2005)
- Leung TY, "Trends in maternal obesity and associated risks of adverse pregnancy outcomes in a population of Chinese women", BJOG, 115, pp.1529~1537 (2008)
- McDonald SD, "Maternal overweight and obesity and the risk of preterm birth and low birth weight: a systematic review and meta-analyses", BMJ, 341, pp.3428~ (2010)
- Molarius A, "Smoking and relative body weight: an international perspective from the WHO MONICA Project", J Epidemiol Community Health, 51, pp.252~260 (1997)
- Nohr EA, "Obesity, gestationalweight gain and pretermbirth: a studywithin the Danish National Birth Cohort", Paediatr Perinat Epidemiol, 21, pp.5~14 (2007)
- Rode L, "Obesity- related complications in Danish single cephalic term pregnancies", Obstet Gynecol, 105, pp.537~542 (2005)
- Roman H, "Maternal body mass index at delivery and risk of caesarean due to dystocia in low risk pregnancies", Acta Obstet Gynecol Scand, 87, pp.163~170 (2008)
- Sebire NJ, "Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London", Int J Obes Relat Metab Disord, 25, pp.1175~1182 (2001)
- Sebire NJ, "Is maternal underweight really a risk factor for adverse pregnancy outcome? A population-based study in London", BJOG, 108, pp.61~66 (2001)
- Siega-Riz AM, "Maternal underweight status and inadequate rate of weight gain during the third trimester of pregnancy increases the risk of preterm delivery", J Nutr, 126, pp.146~153 (1996)
- Smith GCS, "Maternal obesity in early pregnancy and risk of spontaneous and elective preterm deliveries: a retrospective cohort study", Am J Public Health, 97, pp.157~162 (2007)
- Yi SW, "Body Mass Index and Stroke Mortality by Smoking and Age at Menopause Among Korean Postmenopausal Women", STROKE, 40(11), pp.3428~3435
- "Global Database on Body Mass Index"[URL]
- Obesity: preventing and managing the global epidemic. Report of a WHO Consultation, "WHO", World Health Organization, 1~4, pp.WHO technical report series 894 (2000)