Dodds Linda, Fell Deshayne B, Joseph K S, Allen Victoria M, Butler Blair
Perinatal Epidemiology Research Unit, Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, Nova Scotia, Canada.
Obstet Gynecol. 2006 Feb;107(2 Pt 1):285-92. doi: 10.1097/01.AOG.0000195060.22832.cd.
To evaluate maternal and neonatal outcomes among women with hyperemesis during pregnancy.
A population-based retrospective cohort study was conducted among women with singleton deliveries between 1988 and 2002. Hyperemetic pregnancies were defined as those requiring one or more antepartum admissions for hyperemesis before 24 weeks of gestation. Severity of hyperemesis was evaluated according to the number of antenatal hospital admissions (1 or 2 versus 3 or more) and according to weight gain during pregnancy (< 7 kg [15.4 lb] versus > or = 7 kg). Maternal outcomes evaluated included weight gain during pregnancy, gestational diabetes, gestational hypertension, labor induction, and cesarean delivery. Neonatal outcomes included 5-minute Apgar score of less than 7, low birth weight, small for gestational age, preterm delivery, and perinatal death. Logistic regression was used to generate adjusted odds ratios for all outcomes, and the odds ratios were converted to relative risks.
Of the 156,091 singleton pregnancies, 1,270 had an admission for hyperemesis. Compared to women without hyperemesis, infants born to women with hyperemesis and with low pregnancy weight gain (< 7 kg [15.4 lb]) were more likely to be low birth weight, small for gestational age (SGA), born before 37 weeks of gestation, and have a 5-minute Apgar score of less than 7. Compared with infants born to women without hyperemesis, rates of low birth weight and preterm delivery were substantially higher among infants born to women with hyperemesis and low pregnancy weight gain (4.2% versus 12.5% and 4.9% versus 13.9%, respectively). The outcomes among infants born to women with hyperemesis with pregnancy weight gain of 7 kg (15.4 lb) or more were not different from the outcomes among women without hyperemesis.
The results of this study suggest that the adverse infant outcomes associated with hyperemesis are a consequence of, and mostly limited to, women with poor maternal weight gain.
II-2.
评估妊娠期剧吐女性的母婴结局。
对1988年至2002年间单胎分娩的女性进行基于人群的回顾性队列研究。剧吐妊娠定义为在妊娠24周前因剧吐需要1次或多次产前住院治疗的妊娠。根据产前住院次数（1或2次与3次或更多次）以及孕期体重增加情况（<7千克[15.4磅]与≥7千克）评估剧吐的严重程度。评估的母亲结局包括孕期体重增加、妊娠期糖尿病、妊娠期高血压、引产和剖宫产。新生儿结局包括5分钟阿氏评分低于7分、低出生体重、小于胎龄儿、早产和围产期死亡。采用逻辑回归分析得出所有结局的调整比值比，并将比值比转换为相对风险。
在156,091例单胎妊娠中，1270例因剧吐住院。与无剧吐的女性相比，剧吐且孕期体重增加少（<7千克[15.4磅]）的女性所生婴儿更有可能低出生体重、小于胎龄儿、在妊娠37周前出生且5分钟阿氏评分低于7分。与无剧吐女性所生婴儿相比，剧吐且孕期体重增加少的女性所生婴儿的低出生体重率和早产率显著更高（分别为4.2%对12.5%以及4.9%对13.9%）。孕期体重增加7千克（15.4磅）或更多的剧吐女性所生婴儿的结局与无剧吐女性所生婴儿的结局无差异。
本研究结果表明，与剧吐相关的不良婴儿结局是母亲体重增加不佳的结果，且大多局限于此。
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