孕产妇肥胖与围产期和后代结局:综述

IF 21.4 1区 心理学 Q1 MULTIDISCIPLINARY SCIENCES
Ziyi Yang, Gengchen Feng, Xueying Gao, Xueqi Yan, Yimeng Li, Yuteng Wang, Shumin Li, Yonghui Jiang, Shigang Zhao, Han Zhao, Zi-Jiang Chen
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引用次数: 0

摘要

孕产妇肥胖会对产科健康产生有害影响,并对后代造成长期不良后果。在此,我们对194项观察性荟萃分析、10项孟德尔随机研究和748项干预性荟萃分析进行了综述,以评估已发表的有关孕产妇肥胖与围产期和后代结局之间关系的证据。证据分级表明,17 项(8.8%)观察性荟萃分析在以下 12 项结果上有令人信服的证据支持:产妇肥胖与引产后剖宫产风险增加、婴儿死亡率、1 分钟内 Apgar 评分 <7 、产前抑郁、后代超重和肥胖、女儿青春期开始时间提前、注意力缺陷多动症、脑瘫、先天性心脏病和脊柱裂相关(OR/RR 从 1.14 到 2.31 不等)。14 到 2.31),以及后代体脂率和脂肪量增加(SMD 分别为 0.31 和 0.35)。在这些结果中,干预性荟萃分析支持产妇减肥干预能显著降低产前抑郁的风险,但不能降低低Apgar评分;这些干预也不能降低后代的脂肪量或体脂率。孟德尔随机化研究的证据表明,孕产妇肥胖与妊娠糖尿病、先兆子痫、新生儿体型和后代肥胖之间存在因果关系。我们的研究结果突出表明,虽然观察性荟萃分析显示了母体脂肪与各种围产期和后代不良结局之间的关联,但令人信服的、无偏见的证据或孟德尔随机研究的支持却很有限。对孕产妇进行孕前和产前减肥干预可以减少部分不良影响,但并非全部。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Maternal adiposity and perinatal and offspring outcomes: an umbrella review

Maternal adiposity and perinatal and offspring outcomes: an umbrella review

Maternal adiposity and perinatal and offspring outcomes: an umbrella review
Maternal adiposity deleteriously affects obstetrical health and has been associated with long-term adverse consequences in offspring. Here we conducted an umbrella review encompassing 194 observational meta-analyses, 10 Mendelian randomization studies and 748 interventional meta-analyses to appraise the published evidence on the associations between maternal adiposity and perinatal and offspring outcomes. Evidence grading suggested that 17 (8.8%) observational meta-analyses were supported by convincing evidence for 12 outcomes: maternal adiposity was associated with an increased risk of caesarean delivery following labour induction, infant mortality, Apgar score <7 at 1 min, antenatal depression, offspring overweight and obesity, early timing of puberty onset in daughters, attention deficit hyperactivity disorder, cerebral palsy, congenital heart disease and spina bifida (OR/RR ranging from 1.14 to 2.31), as well as increased offspring body fat percent and fat mass (SMD 0.31 and 0.35, respectively). Among these outcomes, interventional meta-analyses supported that maternal weight loss interventions significantly reduced the risk of antenatal depression but not low Apgar scores; these interventions also could not reduce offspring fat mass or body fat percent. Evidence from Mendelian randomization studies supported a causal relationship between maternal adiposity and gestational diabetes mellitus, preeclampsia, birth size and offspring adiposity. Our findings highlight that while observational meta-analyses reveal associations between maternal adiposity and various adverse perinatal and offspring outcomes, convincing, unbiased evidence or support from Mendelian randomization studies is limited. Maternal pre-conceptional and prenatal weight loss interventions can reduce some, but not all, of these adverse effects. This umbrella review of 194 observational meta-analyses and 748 interventional studies finds that maternal adiposity is associated with 12 adverse perinatal and offspring outcomes. Maternal weight loss interventions can only reduce some of these effects.
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来源期刊
Nature Human Behaviour
Nature Human Behaviour Psychology-Social Psychology
CiteScore
36.80
自引率
1.00%
发文量
227
期刊介绍: Nature Human Behaviour is a journal that focuses on publishing research of outstanding significance into any aspect of human behavior.The research can cover various areas such as psychological, biological, and social bases of human behavior.It also includes the study of origins, development, and disorders related to human behavior.The primary aim of the journal is to increase the visibility of research in the field and enhance its societal reach and impact.
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