Lombardi David G, Barton John R, O'Brien John M, Istwan Niki K, Sibai Baha M
Department of Obstetrics and Gynecology, University of Kentucky, Lexington, USA.
Am J Obstet Gynecol. 2005 May;192(5):1472-4. doi: 10.1016/j.ajog.2004.12.072.
This study was undertaken to determine the influence of increased prepregnancy body mass index (BMI) on pregnancy outcome in women with mild gestational hypertension remote from term.
A matched cohort design was used. A total of 365 pregnant women with mild gestational hypertension and a normal prepregnancy BMI (20-25 kg/m2) were matched 1:1 for gestational age at diagnosis, race and parity to 365 women with mild gestational hypertension, but an obese prepregnancy BMI (> or = 30 kg/m2).
Matched characteristics were distributed as follows: gestational age at diagnosis 32.2 +/- 2.4 weeks; race 80.8% white; parity 59.7% nulliparous. The rate of progression to preeclampsia was the primary endpoint of the study and was similar between the prepregnancy normal and obese BMI groups (37.8% vs 41.1%, P = .352). Birth weight at delivery (3033 +/- 747 g vs 2833 +/- 659 g, P < .001) and cesarean delivery rate (56.7% vs 40.3%, P < .001) were greater in the obese prepregnancy BMI group.
In patients with mild gestational hypertension remote from term, an obese prepregnancy BMI was associated with similar rates of progression to preeclampsia. Secondarily, an obese prepregnancy BMI was associated with higher birth weights and an increased incidence of cesarean delivery.
本研究旨在确定孕前体重指数（BMI）增加对孕周尚早的轻度妊娠期高血压女性妊娠结局的影响。
采用匹配队列设计。总共365例孕前BMI正常（20 - 25kg/m²）的轻度妊娠期高血压孕妇，按照诊断时的孕周、种族和产次1:1匹配365例孕前BMI肥胖（≥30kg/m²）的轻度妊娠期高血压女性。
匹配特征分布如下：诊断时孕周32.2±2.4周；种族80.8%为白人；产次59.7%为初产妇。子痫前期进展率是研究的主要终点，孕前BMI正常组和肥胖组相似（37.8%对41.1%，P = 0.352）。孕前肥胖BMI组的分娩出生体重（3033±747g对2833±659g，P < 0.001）和剖宫产率（56.7%对40.3%，P < 0.001）更高。
在孕周尚早的轻度妊娠期高血压患者中，孕前肥胖BMI与子痫前期进展率相似。其次，孕前肥胖BMI与更高的出生体重和剖宫产发生率增加有关。
