Kim Yeon Hee, Lee Hee Joung, Shin Jae Eun, Lee Young, Shin Jong Chul, Park Tae Chul, Park In Yang
Department of Obstetrics and Gynecology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Republic of Korea.
Department of Obstetrics and Gynecology, Yeouido St. Mary's Hospital, The Catholic University of Korea, Republic of Korea.
Obes Res Clin Pract. 2015 Jul-Aug;9(4):374-81. doi: 10.1016/j.orcp.2014.12.001. Epub 2014 Dec 19.
To identify the correlation between the pre-gravid maternal obesity and the uterine artery pulsatility index (UtA-PI) at 28-34 weeks' gestation, and to evaluate the predictive value of the UtA-PI for the occurrence of adverse outcomes depending on the maternal obesity.
Between January 2010 and December 2011, 229 pregnant women were prospectively observed and analyzed. The UtA-PI during 28-34 weeks' gestation was estimated, with abnormal UtA-PI defined if the value was above the 95th centile for gestational age. The patients were classified, using a cut-off value for body mass index (BMI) of 25kg/m(2), into obese (pre-gravid BMI≥25kg/m(2)) and non-obese (pre-gravid BMI<25kg/m(2)) groups. We analyzed the association between the pre-gravid BMI and occurrence of abnormal UtA-PI and estimated their contributions to adverse outcomes using regression analyses.
The occurrence of abnormal UtA-PI in the women with pre-gravid BMI over 25kg/m(2) was significantly higher than those with normal pre-gravid BMI (OR: 2.49; 95% CI: 1.22-5.12). In multivariate analyses, the combination with abnormal UtA-PI and pre-gravid BMI over 25kg/m(2) contributed to the occurrence of preterm delivery (OR: 33.5; 95% CI: 7.63-147.21), gestational diabetes (OR: 3.98; 95% CI: 1.17-13.56) and pregnancy induced hypertension (OR: 12.71; 95% CI: 3.45-46.87), compared to the control group with pre-gravid BMI of 25kg/m(2) and less, and normal UtA-PI.
Women with pre-gravid BMI over 25kg/m(2) show increased tendency of abnormal uterine artery pulsatility index during 28-34 weeks, which increases the risk of adverse pregnancy outcomes.
确定孕前孕妇肥胖与妊娠28 - 34周时子宫动脉搏动指数（UtA-PI）之间的相关性，并评估根据孕妇肥胖情况UtA-PI对不良结局发生的预测价值。
在2010年1月至2011年12月期间，对229名孕妇进行前瞻性观察和分析。估计妊娠28 - 34周期间的UtA-PI，若该值高于胎龄的第95百分位数则定义为UtA-PI异常。使用体重指数（BMI）25kg/m²的临界值将患者分为肥胖组（孕前BMI≥25kg/m²）和非肥胖组（孕前BMI<25kg/m²）。我们分析了孕前BMI与UtA-PI异常发生之间的关联，并使用回归分析估计它们对不良结局的影响。
孕前BMI超过25kg/m²的女性中UtA-PI异常的发生率显著高于孕前BMI正常的女性（比值比：2.49；95%置信区间：1.22 - 5.12）。在多变量分析中，与孕前BMI为25kg/m²及以下且UtA-PI正常的对照组相比，UtA-PI异常与孕前BMI超过25kg/m²的组合会导致早产（比值比：33.5；95%置信区间：7.63 - 147.21）、妊娠期糖尿病（比值比：3.98；95%置信区间：1.17 - 13.56）和妊娠高血压（比值比：12.71；95%置信区间：3.45 - 46.87）的发生。
孕前BMI超过25kg/m²的女性在妊娠28 - 34周期间子宫动脉搏动指数异常的倾向增加，这增加了不良妊娠结局的风险。
