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孕妇 BMI 增加与妊娠期间轻微并发症风险增加相关,从而导致成本增加。

Increased maternal BMI is associated with an increased risk of minor complications during pregnancy with consequent cost implications.

机构信息

Centre for Reproductive Biology, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.

出版信息

BJOG. 2009 Oct;116(11):1467-72. doi: 10.1111/j.1471-0528.2009.02222.x. Epub 2009 Jun 4.

Abstract

OBJECTIVE

To investigate the effect of maternal body mass index (BMI) on minor complications, associated additional medication use during pregnancy and the consequent cost implications.

DESIGN

Retrospective analysis of case notes.

SETTING

Labour wards, tertiary referral hospital, Royal Infirmary Edinburgh, UK. Population Six hundred and fifty-one women with a singleton pregnancy over four separate time periods in 2007 and 2008.

METHODS

Descriptive statistics, univariate and multivariate logistic regression analysis and cost analysis using standard techniques and inflation indices.

MAIN OUTCOME MEASURES

Minor complications, use of medications during pregnancy and consequent incremental costs from the perspective of the National Health Service (NHS).

RESULTS

42.4% of women were overweight or obese (BMI > or = 25 kg/m(2)). Higher BMI during the first trimester (BMI > or = 30 kg/m(2) compared with BMI < 25 kg/m(2)) was associated with an increased risk of minor complications including symphysis pubis dysfunction (OR 3.97; 95% CI 2.19-7.18), heartburn (OR 2.65; 95% CI 1.42-4.94) and chest infection (OR 8.71; 95% 2.20-34.44) and with drugs used to treat these complications including Gaviscon (OR 3.52; 95% CI 1.78-6.96). The mean incremental (additional) NHS costs per woman for treating minor complications increased with maternal BMI were 15.45 pounds/woman, 17.64 pounds/woman and 48.66 pounds/woman for BMI < 25 kg/m(2), BMI > or = 25 to <30 kg/m(2) and BMI > or = 30 kg/m(2) respectively.

CONCLUSIONS

Increased maternal BMI is associated with increased risk of developing minor complications during pregnancy; use of medications associated with treating these conditions and has significant NHS costs.

摘要

目的

研究母体体重指数(BMI)对母婴并发症、孕期附加药物使用的影响及其产生的成本。

设计

病历回顾性分析。

地点

英国爱丁堡皇家医院产科病房,三级转诊医院。

人群

2007 年和 2008 年四个不同时期 651 名单胎妊娠妇女。

方法

采用描述性统计、单变量和多变量逻辑回归分析及标准技术和通胀指数进行成本分析。

主要观察指标

母婴并发症、孕期药物使用及国家医疗服务体系(NHS)的增量成本。

结果

42.4%的孕妇超重或肥胖(BMI≥25kg/m²)。与 BMI<25kg/m²相比,孕早期 BMI≥30kg/m²与母婴并发症风险增加相关,包括耻骨联合功能障碍(OR 3.97;95% CI 2.19-7.18)、烧心(OR 2.65;95% CI 1.42-4.94)和胸部感染(OR 8.71;95% CI 2.20-34.44),以及治疗这些并发症的药物,包括 Gaviscon(OR 3.52;95% CI 1.78-6.96)。治疗母婴并发症的 NHS 增量成本(每位女性额外支出)随母体 BMI 增加而增加,BMI<25kg/m²、BMI≥25kg/m²且<30kg/m²和 BMI≥30kg/m²的女性分别为 15.45 英镑/人、17.64 英镑/人和 48.66 英镑/人。

结论

母体 BMI 增加与孕期母婴并发症风险增加相关;使用与治疗这些疾病相关的药物会产生显著的 NHS 成本。

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