Rastogi Shantanu, Rojas Mary, Rastogi Deepa, Haberman Shoshana
Division of Neonatology, Department of Pediatrics .
J Matern Fetal Neonatal Med. 2015 May;28(7):829-35. doi: 10.3109/14767058.2014.935324. Epub 2014 Jul 11.
Impact of maternal obesity on full-term neonates is not known.
We hypothesized increased incidence of neonatal morbidities requiring NICU admission in full-term neonates of obese women compared to neonates of normal-weight women.
Data from full-term pregnancies collected in the Consortium of Safe Labor study were analyzed. Maternal BMI was classified using the WHO criteria. Incidence of neonatal outcomes including sepsis, PDA, NEC, respiratory distress, or their combination were compared between newborns of obese and normal-weight women.
Of the 109 488 women included in the study, 17.7% were obese. Maternal co-morbidities (diabetes, gestational diabetes, hypertension, and preeclampsia) increased with increasing maternal BMI. Both maternal obesity and its related co-morbidities were associated with higher incidence of neonatal morbidities. After adjusting for maternal comorbidities, there was a higher incidence of sepsis (AOR 1.91(1.45-2.50)), and combination of any of the neonatal outcomes (AOR 1.66(1.32-2.09)) among newborns of obese women than those of normal-weight women, along with an increased trend for incidence of PDA (Cochran-Armitage Test (CA) = 23.1, p < 0.0001) and NEC (CA = 7.2, p = 0.007).
Maternal obesity is independently associated with increased incidence of neonatal sepsis and a combination of neonatal morbidities in full-term newborns with an increased trend for PDA and NEC.
母亲肥胖对足月儿的影响尚不清楚。
我们假设,与正常体重女性的新生儿相比,肥胖女性的足月儿因新生儿疾病而需入住新生儿重症监护病房(NICU)的发生率更高。
分析了安全分娩研究联盟收集的足月妊娠数据。根据世界卫生组织(WHO)标准对母亲的体重指数(BMI)进行分类。比较肥胖和正常体重女性新生儿的新生儿结局(包括败血症、动脉导管未闭、坏死性小肠结肠炎、呼吸窘迫或其组合)的发生率。
在纳入研究的109488名女性中,17.7%为肥胖。母亲的合并症(糖尿病、妊娠期糖尿病、高血压和先兆子痫)随母亲BMI的增加而增加。母亲肥胖及其相关合并症均与新生儿疾病的较高发生率相关。在对母亲合并症进行调整后,肥胖女性新生儿的败血症发生率(调整后的比值比[AOR]为1.91[1.45 - 2.50])以及任何新生儿结局的组合发生率(AOR为1.66[1.32 - 2.09])均高于正常体重女性新生儿,同时动脉导管未闭( Cochr an - Armitage检验[CA]=23.1,p<0.0001)和坏死性小肠结肠炎(CA = 7.2,p = 0.007)的发生率有增加趋势。
母亲肥胖与足月新生儿败血症发生率增加以及新生儿疾病组合独立相关,动脉导管未闭和坏死性小肠结肠炎有增加趋势。