Association of parental pre-pregnancy body mass index with macrosomia
YANG Guihong1, WEI Jianhui2, DENG Fang1, LI Yunfei1, JIAO Ling1, QIN Jiabi2
1. Hunan Children’s Hospital, Changsha, Hunan 410007, China; 2. Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan 410078, China
Abstract：Objective To explore the association between parental pre-pregnancy body mass index (BMI) and its interaction with the incidence of macrosomia, and to provide a scientific basis for body weight management of pregnant couples as well as macrosomia prevention and control. Methods A prospective cohort study design was used in this study. We constructed a cohort of pregnant women and their husbands undergoing first-trimester prenatal examination in seven maternal and child health care hospitals from August 2014 to December 2019 to serve as the study subjects. And the information was collected through questionnaires, hospital information management system for medical records and follow-up surveys. Logistic regression, restricted cubic spline model and multiplicative interaction model were employed to explore the association of parental pre-pregnancy BMI and its interaction with macrosomia and dose-response relationship. Results A total of 34,104 eligible couples were enrolled into this study, of which 4,920 (14.43%) mothers were underweight before pregnancy, 23,925 (70.15%) mothers had normal body weight, 4,334 (12.71%) mothers were overweight and 925 (2.71%) mothers obese. 1,442 (4.23%) fathers were underweight before pregnancy, 18,118 (53.13%) fathers had normal body weight, 10,592 (31.06%) fathers were overweight and3,952 (11.59%) obese. A total of 1,374 cases of macrosomia were found in the study population, with the prevalence rate being 4.03% (3.82%-4.24%). After adjusting for possible confounders, multifactorial logistic analysis revealed that maternal pre-pregnancy overweight (RR=1.351, 95%CI:1.160-1.573) and obesity (RR=3.883, 95%CI:3.164-4.765) could increase the risk of macrosomia in the offspring, while maternal pre-pregnancy underweight (RR=0.781, 95%CI:0.643-0.950) and paternal pre-pregnancy overweight (RR=0.844, 95%CI:0.743-0.957) could reduce the risk of macrosomia in the offspring. Dose-response relationship analysis displayed agradually rising“J”-shaped non-linear dose-response relationship between maternal pre-pregnancy BMI and macrosomia, while no dose-response relationship was found between paternal pre-pregnancy BMI and macrosomia. Interaction analysis indicated that maternal pre-pregnancy overweight/obesity with paternal underweight (RR=1.966, 95%CI:1.208-3.200), maternal overweight/obesity with paternal normal body weight (RR=1.691, 95%CI:1.422-2.010) and maternal overweight/obesity with paternal overweight/obesity (RR=1.577, 95%CI:1.301-1.912) could increase the risk of macrosomia, while maternal pre-pregnancy underweight with paternal normal body weight (RR=0.661, 95%CI:0.503-0.868) and maternal normal body weight with paternal overweight/obese (RR=0.788, 95%CI:0.683-0.908) could decrease the risk of macrosomia. Conclusion Abnormal parental pre-pregnancy BMI may affect the risk of occurrence of macrosomia in theiroffspring. Health education and guidance should be provided to couples planning pregnancy before conception so as to improve the quality of the birth population.
杨贵红, 魏剑晖, 邓芳, 李运飞, 焦玲, 秦家碧. 父母孕前体质指数与巨大儿的关联研究[J]. 实用预防医学, 2023, 30(12): 1462-1469.
YANG Guihong, WEI Jianhui, DENG Fang, LI Yunfei, JIAO Ling, QIN Jiabi. Association of parental pre-pregnancy body mass index with macrosomia. , 2023, 30(12): 1462-1469.
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