Steinfeld J D, Valentine S, Lerer T, Ingardia C J, Wax J R, Curry S L
Department of Obstetrics and Gynecology, Hartford Hospital, Connecticut, USA.
J Matern Fetal Med. 2000 Jul-Aug;9(4):238-41. doi: 10.1002/1520-6661(200007/08)9:4<238::AID-MFM10>3.0.CO;2-5.
To evaluate racial effects on obstetric complications in obese gravidas.
The obstetric database was reviewed for the period 6/1/94 to 3/31/97. All clinic patients delivering singletons were included. Obesity was defined as a body mass index (BMI) of 29 kg/m2 or more, or a pre-pregnancy weight of 200 pounds or more. Complications studied included hypertension, diabetes, cesarean delivery, and fetal macrosomia.
Of 2,424 eligible subjects, 168 were obese (6.9%). Obese patients had higher rates of chronic hypertension and pregestational diabetes, as well as increased rates of preeclampsia, gestational diabetes, fetal macrosomia, cesarean delivery, and operative vaginal delivery compared to nonobese patients. Of the obese patients, 105 (63%) were Hispanic, 39 (23%) were African American, and 24 (14%) were White; no Asian or Mixed/Other patients were obese. Mean BMIs of the obese subgroups did not differ (P = 0.14), but prepregnancy weights were greater in Whites than Hispanics (P < 0.002). Obese Hispanics had an increased rate of gestational diabetes (P = 0.04) and of infant weight > or =4,500 g (P =.03). Obese Hispanic and African American women were more likely than obese Whites to deliver by cesarean (P = 0.03).
Racial differences affect the complication rates in obese gravidas, and may influence prenatal counseling and pregnancy management.
评估种族对肥胖孕妇产科并发症的影响。
回顾1994年6月1日至1997年3月31日期间的产科数据库。纳入所有分娩单胎的门诊患者。肥胖定义为体重指数（BMI）达到或超过29kg/m²，或孕前体重达到或超过200磅。研究的并发症包括高血压、糖尿病、剖宫产和巨大儿。
在2424名符合条件的受试者中，168名（6.9%）为肥胖者。与非肥胖患者相比，肥胖患者慢性高血压和孕前糖尿病的发生率更高，子痫前期、妊娠期糖尿病、巨大儿、剖宫产和阴道助产的发生率也更高。在肥胖患者中，105名（63%）为西班牙裔，39名（23%）为非裔美国人，24名（14%）为白人；没有亚洲人或其他混血患者肥胖。肥胖亚组的平均BMI无差异（P = 0.14），但白人的孕前体重高于西班牙裔（P < 0.002）。肥胖的西班牙裔妊娠期糖尿病发生率增加（P = 0.04），婴儿体重≥4500g的发生率增加（P = 0.03）。肥胖的西班牙裔和非裔美国女性剖宫产分娩的可能性高于肥胖白人（P = 0.03）。
种族差异影响肥胖孕妇的并发症发生率，并可能影响产前咨询和妊娠管理。
