Joy Saju, Istwan Niki, Rhea Debbie, Desch Cheryl, Stanziano Gary
Wake Forest University, Winston-Salem, North Carolina 27157, USA.
Am J Perinatol. 2009 May;26(5):345-9. doi: 10.1055/s-0028-1110084. Epub 2008 Dec 9.
We investigated the impact of maternal obesity on pregnancy outcomes. Women with normal or obese body mass index (BMI) who delivered singleton infants at term were identified from a perinatal database. Rates of pregnancy complications and neonatal outcomes were compared between women with normal prepregnancy BMI (20 to 24.9 kg/m (2), N = 9171) and those with an obese prepregnancy BMI (> or = 30, N = 3744). Rates of pregnancy complications and neonatal outcomes were also evaluated by the level of obesity (obese [30 to 34.9 kg/m (2), N = 2106], severe obesity [35 to 39.9 kg/m (2), N = 953], and morbid obesity [> or = 40 kg/m (2), N = 685]). Rates of gestational diabetes (12.0% versus 3.7%, P < 0.001, odds ratio [95% confidence interval] = 3.5 [3.0, 4.1]) and gestational hypertension (30.9% versus 9.0%, P < 0.001, odds ratio [95% confidence interval] = 4.5 [4.1, 5.0]) were higher for obese versus normal BMI gravidas, respectively. Women with morbid or severe obesity had a greater incidence of gestational diabetes than women with an obese (30 to 34.9 kg/m (2)) or normal BMI (14.1%, 16.4%, 9.6%, and 3.7%, respectively; P < 0.05). The incidence of gestational hypertension increased with maternal BMI (9.0% normal, 25.5% obese, 33.7% severe, 43.4% morbid; all pairwise comparisons P < 0.05). Obese versus normal BMI was associated with more higher-level nursery admissions (8.2% versus 5.8%) and large-for-gestational age infants (12.3% versus 6.5%; P < 0.001). Obesity places a term pregnancy at risk for adverse maternal and neonatal outcomes.
我们研究了孕妇肥胖对妊娠结局的影响。从围产期数据库中识别出足月分娩单胎婴儿的体重指数（BMI）正常或肥胖的女性。比较孕前BMI正常（20至24.9kg/m²，N = 9171）和孕前BMI肥胖（≥30，N = 3744）的女性的妊娠并发症发生率和新生儿结局。还根据肥胖程度（肥胖[30至34.9kg/m²，N = 2106]、重度肥胖[35至39.9kg/m²，N = 953]和病态肥胖[≥40kg/m²，N = 685]）评估妊娠并发症发生率和新生儿结局。肥胖孕妇的妊娠期糖尿病发生率（12.0%对3.7%，P<0.001，优势比[95%置信区间]=3.5[3.0,4.1]）和妊娠期高血压发生率（30.9%对9.0%，P<0.001，优势比[95%置信区间]=4.5[4.1,5.0]）分别高于BMI正常的孕妇。病态或重度肥胖的女性妊娠期糖尿病发生率高于肥胖（30至34.9kg/m²）或BMI正常的女性（分别为14.1%、16.4%、9.6%和3.7%；P<0.05）。妊娠期高血压的发生率随孕妇BMI升高而增加（正常为9.0%，肥胖为25.5%，重度为33.7%，病态为43.4%；所有两两比较P<0.05）。与BMI正常相比，肥胖与更多的高级护理病房收治（8.2%对5.8%）和大于胎龄儿（12.3%对6.5%；P<0.001）相关。肥胖使足月妊娠面临不良孕产妇和新生儿结局的风险。
