Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Miller University of Miami School of Medicine, Miami, Florida 33101, USA.
Am J Perinatol. 2010 Apr;27(4):333-8. doi: 10.1055/s-0029-1243304. Epub 2009 Dec 10.
We evaluated pregnancy outcomes in obese women with excessive weight gain during pregnancy. A retrospective study was performed on all obese women. Outcomes included rates of preeclampsia (PEC), gestational diabetes, cesarean delivery (CD), preterm delivery, low birth weight, very low birth weight, macrosomia, 5-minute Apgar score of <7, and neonatal intensive care unit (NICU) admission and were stratified by body mass index (BMI) groups class I (BMI 30 to 35.9 kg/m(2)), class II (36 to 39.9 kg/m(2)), and class III (>or=40 kg/m(2)). Gestational weight change was abstracted from the mother's medical chart and was divided into four categories: weight loss, weight gain of up to 14.9 pounds, weight gain of 15 to 24.9 pounds, and weight gain of more than 25 pounds. A total 20,823 obese women were eligible for the study. Univariate analysis revealed higher rates of preeclampsia, gestational diabetes, Cesarean deliveries, preterm deliveries, low birth weight, macrosomia, and NICU admission in class II and class III obese women when compared with class I women. When different patterns of weight gain were used as in the logistic regression model, rates of PEC and CD were increased. Excessive weight gain among obese women is associated with adverse outcomes with a higher risk as BMI increases.
我们评估了孕期体重过度增加的肥胖女性的妊娠结局。对所有肥胖女性进行了回顾性研究。结局包括子痫前期（PEC）、妊娠期糖尿病、剖宫产（CD）、早产、低出生体重、极低出生体重、巨大儿、5 分钟 Apgar 评分<7、新生儿重症监护病房（NICU）入院的发生率，并按体重指数（BMI）分组进行分层：I 组（BMI 30 至 35.9 kg/m(2)）、II 组（36 至 39.9 kg/m(2)）和 III 组（≥40 kg/m(2)）。从母亲的病历中提取了妊娠体重变化，并分为四个类别：体重减轻、体重增加不超过 14.9 磅、体重增加 15 至 24.9 磅和体重增加超过 25 磅。共有 20823 名肥胖女性符合研究条件。单因素分析显示，与 I 组女性相比，II 组和 III 组女性的子痫前期、妊娠期糖尿病、CD、早产、低出生体重、巨大儿和 NICU 入院发生率更高。当使用逻辑回归模型中的不同体重增加模式时，PEC 和 CD 的发生率增加。肥胖女性体重过度增加与不良结局相关，BMI 增加风险更高。
