Walsh Jennifer, Foley Michael, O'Herlihy Colm
Department of Obstetrics and Gynecology, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.
J Matern Fetal Neonatal Med. 2011 Jun;24(6):817-21. doi: 10.3109/14767058.2010.531313. Epub 2010 Dec 15.
To assess the influence of body mass index (BMI) on labor outcome in both induced and actively managed spontaneous nulliparous labors.
This is a prospective observational study of all consecutive nulliparous women who delivered in the National Maternity Hospital, Dublin in 2008. Labor outcome variables examined in relation to BMI included duration of labor, oxytocin requirements, epidural use, mode of delivery, and infant birthweight.
Of 4162 nulliparous women who labored during the study period, accurate BMI data were available on 3158, who constituted the study group. Of these women, 2143 (68%) were in spontaneous labor and 1015 (32%) had labor induced. A statistically significant association was found between maternal BMI at first antenatal visit and the need for intrapartum cesarean section (CS) in both spontaneous and induced labors (p < 0.05). A significantly poorer response to oxytocin augmentation was observed in women with a higher BMI, as indicated by an increased intrapartum CS rate for dystocia despite oxytocin augmentation. There was a linear relationship between maternal BMI and gestational age at onset of spontaneous labor.
Our results in a large consecutive series of nulliparous labors confirm the potent influence of increasing maternal BMI on intrapartum events.
评估体重指数（BMI）对引产及积极管理的初产妇自然分娩结局的影响。
这是一项对2008年在都柏林国家妇产医院分娩的所有连续初产妇进行的前瞻性观察研究。与BMI相关的分娩结局变量包括产程时长、催产素使用量、硬膜外麻醉使用情况、分娩方式及婴儿出生体重。
在研究期间分娩的4162名初产妇中，3158名有准确的BMI数据，构成研究组。其中，2143名（68%）为自然分娩，1015名（32%）为引产。在初诊时孕妇的BMI与自然分娩和引产时产时剖宫产（CS）的需求之间均发现有统计学意义的关联（p < 0.05）。BMI较高的女性对催产素增强宫缩的反应明显较差，表现为尽管使用了催产素增强宫缩，但因难产而行产时剖宫产的比例增加。孕妇BMI与自然分娩开始时的孕周之间存在线性关系。
我们在大量连续初产妇分娩系列中的研究结果证实，孕妇BMI升高对产时情况有显著影响。
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