Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide 5005, South Australia.
BMC Pregnancy Childbirth. 2010 Sep 17;10:56. doi: 10.1186/1471-2393-10-56.
The prevalence of obesity amongst women bearing children in Australia is rising and has important implications for obstetric care. The aim of this study was to assess the prevalence and impact of mothers being overweight and obese in early to mid-pregnancy on maternal, peripartum and neonatal outcomes.
A secondary analysis was performed on data collected from nulliparous women with a singleton pregnancy enrolled in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS). Women were categorized into three groups according to their body mass index (BMI): normal (BMI 18.5-24.9 kg/m2); overweight (BMI 25-29.9 kg/m2) and; obese (BMI 30-34.9 kg/m2). Obstetric and perinatal outcomes were compared by univariate and multivariate analyses.
Of the 1661 women included, 43% were overweight or obese. Obese women were at increased risk of pre-eclampsia (relative risk (RR) 2.99 [95% confidence intervals (CI) 1.88, 4.73], p < 0.0001) and gestational diabetes (RR 2.10 [95%CI 1.17, 3.79], p = 0.01) compared with women with a normal BMI. Obese and overweight women were more likely to be induced and require a caesarean section compared with women of normal BMI (induction - RR 1.33 [95%CI 1.13, 1.57], p = 0.001 and 1.78 [95%CI 1.51, 2.09], p < 0.0001, caesarean section - RR 1.42 [95%CI 1.18, 1.70], p = 0.0002 and 1.63 [95%CI 1.34, 1.99], p < 0.0001). Babies of women who were obese were more likely to be large for gestational age (LFGA) (RR 2.08 [95%CI 1.47, 2.93], p < 0.0001) and macrosomic (RR 4.54 [95%CI 2.01, 10.24], p = 0.0003) compared with those of women with a normal BMI.
The rate of overweight and obesity is increasing amongst the Australian obstetric population. Women who are overweight and obese have an increased risk of adverse pregnancy outcomes. In particular, obese women are at increased risk of gestational diabetes, pregnancy induced hypertension and pre-eclampsia. Effective preventative strategies are urgently needed.
Current Controlled Trials ISRCTN00416244.
澳大利亚生育期妇女肥胖症的流行率正在上升，这对产科护理有重要影响。本研究旨在评估母亲在妊娠早期至中期超重和肥胖对产妇、围产期和新生儿结局的影响。
对澳大利亚抗氧化剂维生素 C 和维生素 E 补充剂预防子痫前期合作试验（ACTS）中纳入的初产妇单胎妊娠数据进行二次分析。根据体重指数（BMI）将妇女分为三组：正常（BMI 18.5-24.9 kg/m2）；超重（BMI 25-29.9 kg/m2）和肥胖（BMI 30-34.9 kg/m2）。通过单变量和多变量分析比较产科和围产期结局。
在 1661 名妇女中，43%超重或肥胖。与 BMI 正常的妇女相比，肥胖妇女子痫前期（相对风险（RR）2.99 [95%置信区间（CI）1.88, 4.73]，p < 0.0001）和妊娠糖尿病（RR 2.10 [95%CI 1.17, 3.79]，p = 0.01）的风险增加。与 BMI 正常的妇女相比，肥胖和超重妇女更有可能接受引产和剖宫产（引产-RR 1.33 [95%CI 1.13, 1.57]，p = 0.001 和 1.78 [95%CI 1.51, 2.09]，p < 0.0001，剖宫产-RR 1.42 [95%CI 1.18, 1.70]，p = 0.0002 和 1.63 [95%CI 1.34, 1.99]，p < 0.0001）。肥胖妇女的婴儿更有可能为巨大儿（RR 2.08 [95%CI 1.47, 2.93]，p < 0.0001）和巨大儿（RR 4.54 [95%CI 2.01, 10.24]，p = 0.0003）。
超重和肥胖在澳大利亚产科人群中的发生率正在上升。超重和肥胖的妇女有发生不良妊娠结局的风险增加。特别是肥胖妇女妊娠糖尿病、妊娠高血压和子痫前期的风险增加。迫切需要有效的预防策略。
当前对照试验 ISRCTN00416244。
