系统综述揭示：女性备孕期BMI过高显著影响生育能力，延长妊娠等待时长

Association between preconception body mass index and fertility in adult female: A systematic review and meta-analysis

成年女性孕前体质量指数与生育能力的关联：一项系统综述和meta分析

Author: Jixing Zhou, Yi Zhang, Yuzhu Teng, Lianjie Dou, Huiru Chen, Fangbiao Tao, Kun Huang 

Source: Obesity Reviews

DOI: 10.1111/obr.13804.

Abstract

Obesity potentially reduces fertility, but systematic reviews are lacking to summarize the existing literature. Therefore, we systematically summarized the association between preconception body mass index (BMI) and fertility in adult female based on existing reports. Up to September 2023, we conducted literature retrievals in different databases, including Web of Science, PubMed, Wiley, and ScienceDirect. Finally, 18 studies were included. Female with overweight/obesity (FOR = 0.85; 95% CI: 0.80, 0.90), obesity (FOR = 0.76; 95% CI: 0.69, 0.83), and overweight (FOR = 0.93; 95% CI: 0.88, 0.99) was associated with the significant time-to-pregnancy (TTP) prolongation (reduced fecundability). Interestingly, underweight was moderately associated with prolonged TTP in females (FOR = 0.95; 95% CI: 0.91, 0.99). Female overweight/obesity was associated with an increased risk of subfecundity (OR = 1.44; 95% CI: 1.20, 1.72) and infertility (OR = 1.60, 95% CI: 1.31-1.94). The findings emphasize the importance of considering appropriate preconception BMI at the population level for female fertility outcomes. In particular, prepregnancy obesity in females is strongly associated with prolonged TTP and increased risk of subfecundity. Scientific management of preconception BMI may improve fertility.

Keywords: obesity; prepregnancy BMI; subfecundity; time‐to‐pregnancy.

摘要

肥胖可能会降低生育能力，但缺乏系统性综述来总结现有文献。因此，我们根据现有的报道，系统地总结了成年女性孕前体质量指数（BMI）与生育能力之间的关系。截至 2023 年 9 月，我们在不同的数据库中进行了文献检索，包括 Web of Science、PubMed、Wiley 和 ScienceDirect。最后，共纳入了 18 项研究。女性超重/肥胖（FOR = 0.85; 95% CI: 0.80, 0.90）、肥胖（FOR = 0.76; 95% CI: 0.69, 0.83）和超重（FOR = 0.93; 95% CI: 0.88, 0.99）与怀孕时间（TTP）显著延长（受孕率降低）有关。有趣的是，女性体重不足与受孕时间延长呈适度相关（FOR = 0.95；95% CI：0.91，0.99）。女性超重/肥胖与亚生育力（OR = 1.44；95% CI：1.20，1.72）和不孕（OR = 1.60，95% CI：1.31-1.94）风险增加有关。研究结果强调了在人群水平上考虑适当的孕前体质量指数对女性生育健康的重要性。尤其是，女性孕前肥胖与 TTP 延长和亚生育力风险增加密切相关。科学管理孕前体重指数可提高生育能力。

关键词：肥胖；孕前BMI；亚生育力；妊娠等待时长。