Saereeporncharenkul Kasem
Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
J Med Assoc Thai. 2011 Mar;94 Suppl 2:S52-8.
To establish the correlation between pre-pregnancy body mass index (BMI) and pregnancy outcomes in Thai women. Cultural modernization has changed lifestyle of Thai population including eating habits, leading to higher incidence of overweight in pregnant woman. This study aims to analyze the relationship between BMI of Thai women before pregnant and pregnancy outcomes.
The study population included 3,715 deliveries in Rajavithi Hospital, Bangkok, Thailand, between January 1, 2009 and December 31, 2009. The number of individuals in each adverse outcomes was compared with those in each BMI group. Odds ratios were calculated using normal BMI as reference.
The overweight and obese BMIs resulted in significant risk of cesarean section, pre-eclampsia and diabetes mellitus with [OR (95% CI)] 1.37 (1.13-1.68), 2.3 (1.4-3.7), 4.02 (2.66-6.08) for overweight and 2.11 (1.53-2.90), 5.7 (3.3-9.8), 6.02 (3.52-10.32) for obesity, respectively. The underweight BMI resulted in significant risk of preterm, very preterm, low birthweight (LBW) infant with [OR (95% CI)] 1.79 (1.48-2.16), 1.69 (1.15-2.47), 1.61 (1.27-2.03). Only obesity attributed to significant risk of macrosomia with [OR (95% CI)] 5.36 (2.73-10.52). Both overweight and obesity led to significant risk of postpartum hemorrhage and severe postpartum hemorrhage with [OR (95% CI)] 1.71 (1.21-2.44), 2.13 (1.08-4.22). No correlation was found between pre-pregnancy to stillbirth and congenital anomaly.
Overweight and obesity could increase risk in cesarean section, pre-eclampsia, DM, PPH and severe PPH, but were protective factors of LBW. Only obesity played high risk of macrosomia. Underweight was a protective factor for cesarean section, pre-eclampsia, DM and PPH, but could cause risk in preterm, very preterm and LBW.
建立泰国女性孕前体重指数（BMI）与妊娠结局之间的关联。文化现代化改变了泰国人群的生活方式，包括饮食习惯，导致孕妇超重发生率升高。本研究旨在分析泰国女性孕前BMI与妊娠结局之间的关系。
研究人群包括2009年1月1日至2009年12月31日期间在泰国曼谷拉贾维提医院的3715例分娩。将各不良结局的个体数量与各BMI组的个体数量进行比较。以正常BMI为参照计算比值比。
超重和肥胖的BMI导致剖宫产、先兆子痫和糖尿病的显著风险，超重者的[比值比（95%可信区间）]分别为1.37（1.13 - 1.68）、2.3（1.4 - 3.7）、4.02（2.66 - 6.08），肥胖者分别为2.11（1.53 - 2.90）、5.7（3.3 - 9.8）、6.02（3.52 - 10.32）。体重过轻的BMI导致早产、极早产、低出生体重（LBW）婴儿的显著风险，[比值比（95%可信区间）]分别为1.79（1.48 - 2.16）、1.69（1.15 - 2.47）、1.61（1.27 - 2.03）。只有肥胖归因于巨大儿的显著风险，[比值比（95%可信区间）]为5.36（2.73 - 10.52）。超重和肥胖均导致产后出血和严重产后出血的显著风险，[比值比（95%可信区间）]分别为1.71（1.21 - 2.44）、2.13（1.08 - 4.22）。未发现孕前与死产和先天性异常之间存在关联。
超重和肥胖会增加剖宫产、先兆子痫、糖尿病、产后出血和严重产后出血的风险，但对低出生体重有保护作用。只有肥胖会增加巨大儿的高风险。体重过轻是剖宫产、先兆子痫、糖尿病和产后出血 的保护因素，但可能导致早产、极早产和低出生体重的风险。
