妊娠、肥胖、孕期体重增加和产次作为围产期并发症的预测因素。

Pregnancy, obesity, gestational weight gain, and parity as predictors of peripartum complications.

机构信息

Department of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, 4301 W. Markham St. Slot # 518, Little Rock, AR 72205, USA.

出版信息

Arch Gynecol Obstet. 2011 Oct;284(4):827-36. doi: 10.1007/s00404-010-1754-0. Epub 2010 Nov 12.

DOI:10.1007/s00404-010-1754-0

PMID:21072526

Abstract

PURPOSE

To determine if the best predictor of pregnancy complications is pre-pregnancy body mass index (BMI) alone or in combination with other factors.

METHODS

BMI and peripartum outcomes of singleton pregnancies were evaluated. Recursive partitioning and logistic regression modeling was used.

RESULTS

Of the 4,286 cohorts, 26% were obese (BMI >30 kg/m(2)) and, compared to cohorts with normal weight, at risk for wound infections (P < 0.001), and shoulder dystocia (P < 0.001). High-risk patients (15%; BMI >32.5, parity, pregnancy weight gain of 28 lb by 28 weeks) were at increased risk for wound infection (P < 0.001), endometritis (P < 0.001), shoulder dystocia (P = 0.001) and 5 min Apgar score <4 (P < 0.041) and at lower risk for pre-term delivery (P = 0.007).

CONCLUSIONS

Since BMI, parity, and weight gain until 28 weeks together provide better prediction of peripartum complications than BMI alone, these characteristics can be used to triage and refer patients.

摘要

目的

确定预测妊娠并发症的最佳指标是孕前体重指数（BMI）单独预测，还是与其他因素联合预测。

方法

评估了单胎妊娠的 BMI 和围产期结局。采用递归分区和逻辑回归模型进行分析。

结果

在 4286 个队列中，26%的孕妇肥胖（BMI＞30kg/m2），与体重正常的队列相比，肥胖孕妇发生伤口感染（P＜0.001）和肩难产（P＜0.001）的风险增加。高危患者（15%；BMI＞32.5、多胎妊娠、28 周时体重增加 28 磅）发生伤口感染（P＜0.001）、子宫内膜炎（P＜0.001）、肩难产（P=0.001）和 5 分钟 Apgar 评分＜4（P＜0.041）的风险增加，而早产（P=0.007）的风险降低。