孕前肥胖会影响产科和新生儿结局。

Pre-pregnancy obesity compromises obstetric and neonatal outcomes.

作者信息

Hancke Katharina, Gundelach Theresa, Hay Birgit, Sander Sylvia, Reister Frank, Weiss Jürgen M

出版信息

J Perinat Med. 2015 Mar;43(2):141-6. doi: 10.1515/jpm-2014-0069.

DOI:10.1515/jpm-2014-0069

PMID:24964255

Abstract

OBJECTIVE

Obesity is an important issue among fertile women as it may affect obstetric and neonatal outcomes.

METHODS

Obstetric and neonatal outcomes of primiparous women were retrospectively analyzed in non-obese (n=11387) and obese (n=943) women. A subgroup analysis was performed in obese women divided into three groups: Grade I obesity (Group A, n=654), Grade II obesity (Group B, n=192), and Grade III obesity (Group C, n=97). Odds ratios (OR) were expressed with the corresponding 95% confidence intervals (CI).

RESULTS

The incidence of gestational diabetes (non-obese, 1.9%; obese, 7.6%; Group C, 19.6%) and preeclampsia (non-obese, 3.3%; obese, 13.5%; Group C, 17.5%) increased with rising weight. The risk of non-elective cesarean section was significantly higher in obese women than in non-obese women (21.7% vs. 13.2%). The risk of extreme preterm birth (before 28 weeks of gestation) doubled in the Grade I obesity group (OR, 2.1; 95% CI, 1.4-3.2) and nearly tripled in women with body mass index ≥35 kg/m2 (OR, 2.9; 95% CI, 1.7-4.9).

CONCLUSION

Pre-pregnancy obesity is associated with higher incidences of gestational diabetes and preeclampsia. Our study shows that obese women have a higher risk of non-elective cesarean section and preterm birth.

摘要

目的

肥胖在育龄妇女中是一个重要问题，因为它可能影响产科和新生儿结局。

方法

对非肥胖（n = 11387）和肥胖（n = 943）初产妇的产科和新生儿结局进行回顾性分析。对肥胖妇女进行亚组分析，分为三组：I级肥胖（A组，n = 654）、II级肥胖（B组，n = 192）和III级肥胖（C组，n = 97）。比值比（OR）用相应的95%置信区间（CI）表示。

结果

妊娠期糖尿病的发生率（非肥胖者为1.9%；肥胖者为7.6%；C组为19.6%）和子痫前期的发生率（非肥胖者为3.3%；肥胖者为13.5%；C组为17.5%）随体重增加而升高。肥胖妇女非择期剖宫产的风险显著高于非肥胖妇女（21.7%对13.2%）。I级肥胖组极早产（妊娠28周前）的风险增加一倍（OR，2.1；95%CI，1.4 - 3.2），体重指数≥35 kg/m²的妇女极早产风险几乎增加两倍（OR，2.9；95%CI，1.7 - 4.9）。