Berendzen Jodi A, Howard Bobby C
Department of Obstetrics and Gynecology, University of Tennessee Medical Center, Knoxville, TN, USA.
Tenn Med. 2013 Jan;106(1):35-7, 42.
The purpose of this study was to evaluate the association between cesarean delivery rate and body mass index (BMI) for the patient population served by the University of Tennessee Medical Center in Knoxville, TN.
A retrospective, cohort study was conducted using the perinatal birthlog fromJanuary 1, 2009 through December 31, 2009. The database totaled 2,399 women. Women who delivered > or = 23 weeks gestational age were included. Those missing data imperative to our study (height, weight, mode of delivery) were excluded. Thus, our study included 2,235 women. Cesarean delivery rate was calculated for each of the five BMI categories. Univariate analysis using Chi square, Mann-Whitney U test and independent t-test were used to describe associations between body mass index, mode of delivery and other independent variables. Additional analyses were made on the subset of nulliparous women.
Using prepregnancy BMI, 6.7 percent of our population was underweight, 44.3 percent normal weight, 22.6 percent overweight, 20.6 percent obese, and 5.8 percent morbidly obese. The overall cesarean delivery rate was 36.2 percent. Twenty-six percent of underweight and 31.4 percent of normal weight women required cesarean delivery, while 39.1 percent of overweight, 40.8 percent of obese and 56.6 percent of morbidly obese women required cesarean delivery. In addition to cesarean delivery, hypertensive disorders (OR 3.29; 95% CI 2.51-4.31) and diabetes (OR 5.27; 95% CI 3.73-7.44) complicated significantly more pregnancies of obese women than normal weight women.
There was an increased rate of cesarean delivery as BMI increased. Increased BMI is also associated with other pregnancy complications, including hypertensive disorders and diabetes.
本研究旨在评估田纳西大学诺克斯维尔医学中心服务的患者群体中剖宫产率与体重指数（BMI）之间的关联。
采用回顾性队列研究，使用2009年1月1日至2009年12月31日的围产期出生记录。数据库中有2399名女性。纳入孕周≥23周的分娩女性。排除那些缺少本研究所需数据（身高、体重、分娩方式）的女性。因此，本研究纳入了2235名女性。计算了五个BMI类别中每一类别的剖宫产率。使用卡方检验、曼-惠特尼U检验和独立t检验进行单因素分析，以描述体重指数、分娩方式和其他自变量之间的关联。对未生育女性子集进行了额外分析。
根据孕前BMI，我们的研究人群中6.7%体重过轻，44.3%体重正常，22.6%超重，20.6%肥胖，5.8%病态肥胖。总体剖宫产率为36.2%。体重过轻的女性中有26%、体重正常的女性中有31.4%需要剖宫产，而超重女性中有39.1%、肥胖女性中有40.8%、病态肥胖女性中有56.6%需要剖宫产。除剖宫产外，肥胖女性的妊娠合并高血压疾病（OR 3.29；95% CI 2.51 - 4.31）和糖尿病（OR 5.27；95% CI 3.73 - 7.44）显著多于体重正常的女性。
随着BMI的增加，剖宫产率上升。BMI升高还与其他妊娠并发症相关，包括高血压疾病和糖尿病。
