Metabolic Syndrome in Early Pregnancy and Risk of Preterm Birth

被引:158
作者
Chatzi, Leda [1 ]
Plana, Estel [2 ,3 ,4 ]
Daraki, Vasiliki [5 ]
Karakosta, Polyxeni [1 ]
Alegkakis, Dimitris [6 ]
Tsatsanis, Christos [7 ]
Kafatos, Antonis [1 ]
Koutis, Antonis [1 ]
Kogevinas, Manolis [1 ,3 ,4 ,5 ]
机构
[1] Univ Crete, Fac Med, Dept Social Med, Iraklion 71003, Greece
[2] Ctr Res Environm Epidemiol, Barcelona, Spain
[3] Municipal Inst Med Res, Barcelona, Spain
[4] El Ctr Invest Biomed Red Epidemiol & Salud Publ, Barcelona, Spain
[5] Univ Crete, Fac Med, Dept Endocrinol, Iraklion, Greece
[6] Univ Crete, Fac Med, Dept Rheumatol Clin Immunol & Allergy, Iraklion, Greece
[7] Univ Crete, Fac Med, Dept Clin Chem Biochem, Iraklion, Greece
关键词
fetal growth retardation; metabolic syndrome X; premature birth; CHRONIC HYPERTENSION; RETROSPECTIVE COHORT; INSULIN-RESISTANCE; MATERNAL OBESITY; ASSOCIATION; WEIGHT; EPIDEMIOLOGY; INFLAMMATION; DEFINITION; SINGLETONS;
D O I
10.1093/aje/kwp211
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The authors determined the association between metabolic syndrome in early pregnancy (mean, 11.96 weeks) and the risk of preterm birth in the mother-child cohort study ("Rhea" Study) in Crete, Greece, 2007-2009. Maternal fasting serum samples were collected, and blood pressure was measured at the time of the first major ultrasound examination (n = 625). Multivariable log-binomial regression models were used. Women with metabolic syndrome were at high risk for preterm birth (relative risk (RR) = 2.93, 95% confidence interval (CI): 1.53, 5.58), with the highest risk observed for medically indicated preterm births (RR = 5.13, 95% CI: 1.97, 13.38). Among the components of metabolic syndrome, the most significant risk factor was hypertension (RR = 2.32, 95% CI: 1.28, 4.20). An elevation of 10 mm Hg in diastolic blood pressure increased the relative risk for preterm birth by 29% (RR = 1.29, 95% CI: 1.08, 1.53), while a per unit increase in the low density lipoprotein/high density lipoprotein cholesterol ratio increased this risk by 19% (RR = 1.19, 95% CI: 1.02, 1.39). Fetal weight growth restriction was associated with elevated levels of insulin (RR = 1.14, 95% CI: 1.08, 1.20) and diastolic blood pressure (RR = 1.27, 95% CI: 1.00, 1.61) in early pregnancy. These findings suggest that women with metabolic syndrome in early pregnancy had higher risk for preterm birth.
引用
收藏
页码:829 / 836
页数:8
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