Raja U A, Mcaree T, Bassett P, Sharma S
Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, UK.
J Obstet Gynaecol. 2012 Apr;32(3):247-51. doi: 10.3109/01443615.2011.645920.
This retrospective analysis evaluated the association between maternal body mass index (BMI) and the incidence of maternal and neonatal complications in those women delivering at a North West London hospital between January 2002 and December 2007. Of the women examined, obese mothers (BMI ≥ 30) were shown to be at significantly higher risk from multiple morbidities (p < 0.05), including gestational diabetes; antepartum haemorrhages; pre-term delivery before 37 and 33 weeks' gestation; induction of labour; analgesia use (beyond inhalational methods and local infiltration); caesarean sections; massive postpartum haemorrhages; higher birth weights; Apgar scores < 8 at 1 min and 5 min; cord base deficits less than-12 and a greater need for neonatal care (SCBU, HDU, NICU) compared with mothers with a BMI < 30. These findings add to the growing consensus that obesity increases the risks involved with pregnancy. While information is filtering through to the general public about the overall risks of obesity, more focused pre-pregnancy and inter-pregnancy counselling on the implications of a raised BMI specifically on pregnancy is required at both primary and secondary care sector levels.
这项回顾性分析评估了2002年1月至2007年12月在伦敦西北部一家医院分娩的女性中，孕妇体重指数（BMI）与孕产妇及新生儿并发症发生率之间的关联。在接受检查的女性中，肥胖母亲（BMI≥30）出现多种疾病的风险显著更高（p<0.05），这些疾病包括妊娠期糖尿病、产前出血、妊娠37周和33周前早产、引产、使用镇痛剂（吸入法和局部浸润法以外）、剖宫产、大量产后出血、出生体重较高、1分钟和5分钟时阿氏评分<8、脐血碱缺失小于-12以及相比BMI<30的母亲对新生儿护理（特殊护理婴儿病房、高依赖病房、新生儿重症监护室）的需求更大。这些发现进一步支持了肥胖会增加妊娠相关风险这一日益广泛的共识。虽然关于肥胖总体风险的信息正在向公众渗透，但在初级和二级医疗保健部门层面，都需要针对BMI升高对妊娠的影响，提供更有针对性的孕前和孕间期咨询。
