Menstrual cycle length and adverse pregnancy outcomes among women in Project Viva

被引:4
作者
Soria-Contreras, Diana C. [1 ]
Perng, Wei [2 ,3 ]
Rifas-Shiman, Sheryl L. [4 ,5 ]
Hivert, Marie-France [4 ,5 ,6 ]
Chavarro, Jorge E. [7 ,8 ,9 ]
Oken, Emily [4 ,5 ,7 ]
机构
[1] Natl Inst Publ Hlth, Ctr Nutr & Hlth Res, Cuernavaca, Morelos, Mexico
[2] Univ Colorado, Colorado Sch Publ Hlth, Dept Epidemiol, Aurora, CO USA
[3] Univ Colorado, Lifecourse Epidemiol Adipos & Diabet LEAD Ctr, Colorado Sch Publ Hlth, Dept Epidemiol, Aurora, CO USA
[4] Harvard Med Sch, Dept Populat Med, Div Chron Dis Res Lifecourse, Boston, MA 02115 USA
[5] Harvard Pilgrim Hlth Care Inst, Boston, MA USA
[6] Massachusetts Gen Hosp, Diabet Unit, Boston, MA 02114 USA
[7] Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA
[8] Brigham & Womens Hosp, Dept Med, Channing Div Network Med, 75 Francis St, Boston, MA 02115 USA
[9] Harvard Med Sch, Boston, MA 02115 USA
关键词
adverse pregnancy outcome; birth size; gestational diabetes mellitus; impaired glucose tolerance; menstrual cycle length; preterm birth; POLYCYSTIC-OVARY-SYNDROME; BIRTH-WEIGHT; RISK; HYPERANDROGENEMIA; IRREGULARITY; ADOLESCENCE; INFERTILITY; DISORDERS; MENARCHE; MARKER;
D O I
10.1111/ppe.12866
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Retrospective studies suggest that menstrual cycle length may be a risk marker of adverse pregnancy outcomes, but this evidence is susceptible to recall bias. Objective: To evaluate the prospective association between menstrual cycle length and the risk of adverse pregnancy outcomes. Methods: Secondary analysis of 2046 women enrolled in Project Viva at similar to 10 weeks of gestation and followed through delivery. The exposure was menstrual cycle length. The outcomes included gestational glucose tolerance (gestational diabetes/impaired glucose tolerance [GDM/IGT] and isolated hyperglycaemia), hypertensive disorders of pregnancy (gestational hypertension/preeclampsia), gestational weight gain, birthweight-for-gestational age z-scores (BWZ) categorised in tertiles, preterm birth and birth outcome (live birth and pregnancy loss). We used modified Poisson and multinomial logistic regression adjusted for age, race/ethnicity, parity, age at menarche and pre-pregnancy body mass index. Results: Mean (SD) age at enrolment was 32.1 (4.9) years. Most women (74.3%) had a cycle length of 26-34 days (reference group), 16.2% reported short cycles (<= 25 days), and 9.5% reported long/irregular cycles (>= 35 days/too irregular to estimate). Compared with the reference group, women with short cycles had lower odds of GDM/IGT (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28, 0.89), whereas women with long/irregular cycles had higher odds (OR 1.72, 95% CI 1.04, 2.83). Additionally, women with short cycles had higher odds of having a newborn in the lowest tertile of BWZ (OR 1.45, 95% CI 1.06, 1.98). There was a U-shaped relation between cycle length and preterm birth with both short (relative risk [RR] 1.49, 95% CI 0.98, 2.27) and long/irregular (RR 2.04, 95% CI 1.30, 3.20) cycles, associated with a higher risk. Conclusions: Variation in menstrual cycle length may be a risk marker of GDM/IGT, lower birth size and preterm birth and flag women who may benefit from targeted monitoring and care before and during pregnancy.
引用
收藏
页码:347 / 355
页数:9
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