From the Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark; and the Department of Health Statistics, National Board of Health, Copenhagen, Denmark.
Obstet Gynecol. 2011 Aug;118(2 Pt 1):305-312. doi: 10.1097/AOG.0b013e3182245d49.
To estimate the association between maternal overweight and obesity on complications during pregnancy and delivery in Denmark.
A population-based study on a cohort consisting of all Danish women giving birth to a singleton from 2004 through June 30, 2010 (N = 403,092) was undertaken. Women were identified from the Danish Medical Birth Registry, which contains data on 99.8% of all deliveries in Denmark. Maternal complications during pregnancy and delivery and fetal complications were classified according to the International Classification of Diseases, 10th Revision.
The final study population consisted of 369,347 women, 20.9% being overweight (body mass index [BMI] 25-29.9), 7.7% obese (BMI 30-35), and 4% severely obese (BMI higher than 35). Overweight, obese, and severely obese women had more complications than did normal weight women. Adjusted odds ratios (ORs) were significantly increased as follows: for gestational diabetes mellitus, 3.5, 7.7, and 11.0 for each BMI category; for preeclampsia 1.9, 3, and 4.4. Planned and especially emergency cesarean delivery was significantly increased with increasing BMI (OR ranging from 1.2 to 2.1). The risk of giving birth to a macrosomic neonate (greater than 4,500 g) increased significantly with increasing BMI (1.6, 2.2, and 2.7), as did the risks of having a neonate with a low Apgar score (1.3, 1.4, and 1.9) and having a stillborn fetus (1.4, 1.6, and 1.9). For shoulder dystocia the risk was significantly increased in the unadjusted analysis, but the significance disappeared in the adjusted analysis. No statistically significance was seen for hemorrhage and thrombosis.
This study shows a significant increased risk of a wide variety of pregnancy, birth, and neonatal complications in overweight, obese, and severely obese women.
II.
评估丹麦孕妇超重和肥胖与孕期和分娩并发症的关系。
本研究是基于丹麦的一项队列人群的基于人群的研究，纳入了 2004 年 6 月 30 日前所有单胎分娩的丹麦女性（n=403092）。通过丹麦医学出生登记处获取女性数据，该登记处包含了丹麦所有分娩的 99.8%的数据。根据国际疾病分类第 10 版，对孕期和分娩期间的母体并发症以及胎儿并发症进行分类。
最终的研究人群由 369347 名女性组成，20.9%超重（BMI 25-29.9），7.7%肥胖（BMI 30-35），4%严重肥胖（BMI 高于 35）。与体重正常的女性相比，超重、肥胖和严重肥胖的女性并发症更多。调整后的优势比（OR）显著增加如下：妊娠期糖尿病分别为 3.5、7.7 和 11.0；先兆子痫分别为 1.9、3 和 4.4。随着 BMI 的增加，计划性剖宫产和特别是紧急剖宫产的比例显著增加（OR 范围为 1.2-2.1）。随着 BMI 的增加，巨大儿（大于 4500g）的分娩风险显著增加（1.6、2.2 和 2.7），新生儿低 Apgar 评分（1.3、1.4 和 1.9）和死胎的风险也增加（1.4、1.6 和 1.9）。肩难产的风险在未调整分析中显著增加，但在调整分析中则消失。对于出血和血栓形成，未观察到统计学意义。
本研究表明，超重、肥胖和严重肥胖的孕妇发生各种妊娠、分娩和新生儿并发症的风险显著增加。
II。
