目的 探讨母亲孕前体重指数(BMI)及孕期体重增加与儿童哮喘发生的相关性。方法 共收集2014年1月-2016年1月在本院产科分娩的产妇170例,根据孕前BMI分为正常体重组 (对照组,88例)和肥胖组(82例)。记录其孕前BMI、孕期增重、新生儿情况等用于统计学分析。每年定期进行随访,比较儿童哮喘发生的情况。结果 1)与对照组相比,肥胖组孕期增重正常的比例显著降低,增重超标的比例显著升高(χ2＝12.61、16.94,P<0.01);2)与对照组相比,肥胖组的剖宫产率、巨大儿比例及新生儿BMI均显著升高(P<0.05);3)与对照组相比,肥胖组的总哮喘发生率显著升高,且肥胖组中增重超标的产妇所孕育的儿童哮喘发生率显著升高(χ2＝5.725,5.067;P<0.05)。结论 母亲孕前肥胖且孕期增重超标是诱发儿童哮喘的危险因素,也是导致剖宫产及巨大儿比例升高的主要原因。合理控制孕前BMI及孕期增重,有利于改善妊娠结局并有效控制儿童哮喘的发生率。
Abstract
Objective To investigate the associations of body mass index (BMI) in maternal pre-pregnancy and gestational weight gain with early childhood asthma. Methods A total of 170 women born in the Third Hospital of Xi′an from January 2014 to January 2016 were enrolled.According to the pre-pregnancy BMI,the participants were divided into normal body mass group (control group,n=88) and obesity group (n=82).Pre-pregnancy BMI,gestational weight gain and neonatal status were recorded for statistical analysis.Regular follow-ups were conducted every year and the incidence of asthma in children was compared. Results 1) Compared with control group,the proportion of normal weight gain during pregnancy was significantly lower in the obese group,and the proportion of excessive weight gain was significantly increased (χ2=12.61,16.94,P<0.01).2) Compared with control group,the cesarean section rate,the proportion of giant children and the neonatal BMI significantly increased in the obese group (P<0.05).3) Compared with control group,the total incidence of asthma was significantly higher in the obese group than in the control group,and the incidence of asthma in children whose mother with excessive weight gain in the obese group was significantly higher(χ2=5.725,5.067,P<0.05). Conclusions Pre-pregnancy obesity and excessive gestational weight gain are risk factors for asthma in children,which are also the main reasons of increase in cesarean section and the proportion of macrosomia.Reasonable control of pre-pregnancy BMI and weight gain during pregnancy is beneficial to improving pregnancy outcome and effective control of the incidence of childhood asthma.
关键词
孕前BMI /
孕期增重 /
妊娠结局 /
儿童哮喘
Key words
pre-pregnancy body mass index /
gestational weight gain /
pregnancy outcome /
childhood asthma
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Xiao L,Ding G,Vinturache A,et al.Associations of maternal pre-pregnancy body mass index and gestational weight gain with birth outcomes in Shanghai,China[J].Sci Rep,2017,7:41073.
[2] de Jersey SJ,Mallan KM,Callaway LK,et al.Prospective relationships between health cognitions and excess gestational weight gain in a cohort of healthy and overweight pregnant women[J].J Acad Nutr Diet,2017,117(8):1198-1209.
[3] Yang S,Zhou A,Xiong C,et al.Parental body mass index,gestational weight gain,and risk of macrosomia:a population-based case-control study in China[J].Paediatr Perinat Epidemiol,2015,29(5):462-471.
[4] Harpsøe MC,Basit S,Bager P,et al.Maternal obesity,gestational weight gain,and risk of asthma and atopic disease in offspring:a study within the Danish National Birth Cohort[J].J Allergy Clin Immunol,2013,131(4):1033-1040.
[5] Bobolea I,Arismendi E,Valero A,et al.Early life origins of asthma:a review of potential effectors[J].J Investig Allergol Clin Immunol,2019,29(3):168-179.
[6] 张洋,侯伟.儿童支气管哮喘心理行为问题研究进展[J].中国儿童保健杂志,2019,27(5):523-526.
[7] 中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[8] 王晶晶,王鑫,陈书强,等.孕前BMI与妊娠结局及胎盘转运效率的关系[J].中国妇幼健康研究,2018,29(6):702-705.
[9] 吴爱香,晏星辉,罗爱娟,等.孕期体重变化与胎盘重量和新生儿出生体重间的关系研究[J].现代医院,2017,17(6):893-894,897.
[10] Barker DJ,Gelow J,Thornburg K,et al.The early origins of chronic heart failure:impaired placental growth and initiation of insulin resistance in childhood[J].Eur J Heart Fail,2010,12(8):819-825.
[11] Duijts L.Fetal and infant origins of asthma[J].Eur J Epidemiol,2012,27(1):5-14.
[12] DeVries A,Wlasiuk G,Miller SJ,et al.Epigenome-wide analysis links SMAD3 methylation at birth to asthma in children of asthmatic mothers[J].J Allergy Clin Immunol,2017,140:534-542.
[13] Kooijman MN,Kruithof CJ,van Duijn CM,et al.The Generation R Study:design and cohort update 2017[J].Eur J Epidemiol,2016,31:1243-1264.
[14] Martinez FD,Guerra S.Early Origins of asthma.Role of microbial dysbiosis and metabolic dysfunction[J].Am J Respir Crit Care Med,2018,197(5):573-579.
[15] den Dekker HT,Jaddoe VWV,Reiss IK,et al.Fetal and infant growth patterns and risk of lower lung function and asthma.The Generation R Study[J].Am J Respir Crit Care Med,2018,197(2):183-192.
[16] Thomsen SF,van der Sluis S,Kyvik KO,et al.Estimates of asthma heritability in a large twin sample[J].Clin Exp Allergy,2010,40(7):1054-1061.
[17] Moffatt MF,Gut IG,Demenais F,et al.A large-scale,consortium-based genomewide association study of asthma[J].New Eng J Med,2010,363:1211-1221.
[18] Dijk NF,Xu C,Melén E,et al.Genetic regulation of IL1RL1 methylation and IL1RL1-a protein levels in asthma[J].Eur Respir J,2018,51(3):1701377.
[19] Schedel M,Michel S,Gaertner VD,et al.Polymorphisms related to ORMDL3 are associated with asthma susceptibility,alterations in transcriptional regulation of ORMDL3,and changes in TH2 cytokine levels[J].J Allergy Clin Immunol,2015,136(4):893-903.e14.
[20] Zhang Y,Willis-Owen SAG,Spiegel S,et al.The ORMDL3 asthma gene regulates ICAM1 and has multiple effects on cellular inflammation[J].Am J Respir Crit Care Med,2019,199(4):478-488.
[21] Lowe A,Bråbäck L,Ekeus C,et al.Maternal obesity during pregnancy as a risk for early-life asthma[J].J Allergy Clin Immunol,2011,128(5):1107-1109.e1-2.
[22] 胡芳,卢建军,胡艳,等.剖宫产可能增加儿童罹患过敏性疾病风险的Meta分析[J].中国儿童保健杂志,2018,26(9):985-990.
PDF(409 KB)
