Adherence to Healthy Prepregnancy Lifestyle and Risk of Adverse Pregnancy Outcomes: A Prospective Cohort Study.

IF 4.7 1区医学 Q1 OBSTETRICS & GYNECOLOGY Bjog-An International Journal of Obstetrics and Gynaecology Pub Date : 2024-11-18 DOI:10.1111/1471-0528.17994

Hitomi Okubo, Shoji F Nakayama, Asako Mito, Naoko Arata, Yukihiro Ohya

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Abstract

Objective: To quantify the association between a combination of modifiable prepregnancy lifestyle factors and the risk of adverse pregnancy outcomes (APOs).

Design: Prospective cohort study.

Setting: The Japan Environment and Children's Study.

Population: A total of 79 703 pregnant Japanese women without chronic disease.

Methods: Maternal lifestyle before pregnancy was assessed using a self-administered questionnaire. A healthy lifestyle score (HLS, 0-5 points) was calculated based on adherence to five prepregnancy healthy lifestyle factors: healthy weight, high-quality diet, regular physical activity, not smoking, and not drinking alcohol. Relative risks (RRs) and 95% credible intervals (CrIs) were estimated using a Bayesian log-binomial regression model.

Main outcome measures: Composite APOs, defined as the development of any APO, including gestational diabetes, hypertensive disorders of pregnancy, preterm birth, low birth weight, and small-for-gestational-age, transcribed from medical records.

Results: A total of 13 894 women (17.4%) experienced one or more APOs. HLS was inversely associated with the risk of APOs in a dose-response manner. Women with an HLS of 5 points had a 33% (RR 0.67; 95% CrI, 0.61-0.74) lower risk of APOs than those with the lowest HLS (0-1 points). The population attributable fraction of five healthy lifestyle factors was 10.3%. A 1-point increase of HLS could have reduced APO cases by 6.6%.

Conclusions: A higher HLS was associated with a lower risk of APOs, suggesting that adopting a healthy lifestyle before pregnancy may reduce the risk of APOs, which can increase the risk of future chronic diseases in both mother and child.

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坚持健康的孕前生活方式与不良妊娠结局的风险：前瞻性队列研究

摘要量化可改变的孕前生活方式因素组合与不良妊娠结局（APOs）风险之间的关联：前瞻性队列研究：环境：日本环境与儿童研究：方法：通过对孕前生活方式进行评估，确定孕前生活方式与不良妊娠结局（APOs）之间的关系：方法：采用自填式问卷对孕产妇怀孕前的生活方式进行评估。根据孕前五项健康生活方式因素（健康体重、优质饮食、规律运动、不吸烟、不饮酒）的坚持情况计算出健康生活方式得分（HLS，0-5 分）。采用贝叶斯对数二叉回归模型估算相对风险（RRs）和 95% 可信区间（CrIs）：主要结果测量指标：根据医疗记录转录的复合 APOs，定义为任何 APO 的发生，包括妊娠糖尿病、妊娠高血压疾病、早产、低出生体重和小于胎龄：共有 13 894 名妇女（17.4%）经历过一次或多次妊娠高血压。HLS与发生APO的风险呈剂量反应式的反比关系。健康生活方式指数为 5 分的妇女比健康生活方式指数最低（0-1 分）的妇女发生 APO 的风险低 33% (RR 0.67; 95% CrI, 0.61-0.74)。五项健康生活方式因素的人群可归因比例为 10.3%。结论：健康生活方式指数每增加1分，APO病例就会减少6.6%：结论：较高的健康生活方式指数与较低的 APO 风险相关，这表明在怀孕前采取健康的生活方式可降低 APO 风险，而 APO 可增加母婴未来罹患慢性疾病的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bjog-An International Journal of Obstetrics and Gynaecology 医学-妇产科学

CiteScore

10.90

自引率

5.20%

发文量

345

审稿时长

3-6 weeks

期刊介绍： BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.