Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK.
Fetal Diagn Ther. 2011;30(4):250-65. doi: 10.1159/000328083. Epub 2011 Nov 8.
To examine the association between body mass index (BMI) at 11-13 weeks' gestation and a wide range of adverse pregnancy outcomes after adjustment for confounding factors in obstetric history and maternal characteristics.
This was a prospective screening study for adverse obstetric outcomes in women with singleton pregnancies attending for their first routine hospital visit at 11(+0)-13(+6) weeks of gestation. The maternal weight and height were measured and the BMI was calculated. Regression analysis was performed to examine the association between BMI and each of the adverse pregnancy outcomes.
We examined 41,577 pregnancies with a live fetus at 11-13 weeks. There was a significant contribution from maternal BMI, in addition to maternal characteristics and obstetric history, in the prediction of subsequent miscarriage, stillbirth, preeclampsia, gestational hypertension, gestational diabetes mellitus, delivery of small and large for gestational age neonates, and both elective and emergency cesarean section, but not spontaneous preterm delivery. The risk for each pregnancy complication increased exponentially with BMI, except for delivery of small for gestational age neonates which decreased with BMI.
Maternal BMI at 11-13 weeks can be combined with other maternal characteristics and obstetric history to estimate patient-specific risks for many pregnancy complications.
探讨 11-13 孕周时的体重指数（BMI）与多种不良妊娠结局之间的关联，并在调整产科史和母体特征中的混杂因素后进行分析。
这是一项针对单胎妊娠女性不良产科结局的前瞻性筛查研究，研究对象为在 11（+0）-13（+6）孕周时首次常规医院就诊的孕妇。测量了孕妇的体重和身高，并计算了 BMI。采用回归分析方法来探讨 BMI 与每一种不良妊娠结局之间的关联。
我们检查了 41577 例 11-13 周时有活胎的妊娠。除了母体特征和产科史外，母体 BMI 对随后的流产、死胎、子痫前期、妊娠高血压、妊娠期糖尿病、小于胎龄儿和大于胎龄儿的分娩以及选择性和紧急剖宫产的发生均有显著贡献，但对自发性早产无影响。除了小于胎龄儿的分娩外，每种妊娠并发症的风险均随 BMI 呈指数增加，而小于胎龄儿的分娩则随 BMI 降低。
11-13 孕周时的母体 BMI 可以与其他母体特征和产科史结合，以估计患者多种妊娠并发症的特定风险。
