Suhag Anju, Seligman Neil, Giraldo-Isaza Maria, Berghella Vincenzo
a Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Jefferson Medical College of Thomas Jefferson University , Philadelphia , PA , USA .
b Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , University of Rochester Medical Center , Rochester , NY , USA , and.
J Matern Fetal Neonatal Med. 2016;29(3):368-75. doi: 10.3109/14767058.2015.1006622. Epub 2015 Jan 30.
This study was performed to evaluate the effect of pre-pregnancy body mass index (BMI) on the success of cerclage.
A retrospective cohort study of women who had a history-indicated (HIC) or ultrasound-indicated cerclage (UIC) placed between 1994 and 2011. Based on pre-pregnancy BMI (World Health Organization criteria), three cohorts were defined: normal/overweight (BMI: 20.0-29.9 kg/m(2)), obese class I/II (BMI: 30.0-39.9 kg/m(2)) and obese class III (BMI ≥ 40.0 kg/m(2)). The primary outcome was spontaneous preterm birth (sPTB) <35 weeks. The secondary outcomes included but were not limited to gestational age of delivery, sPTB <37, <32 and <28 weeks, preterm premature rupture of membranes and birth weight.
375 women were included for analysis. Demographics were similar in the three BMI categories, except black race (p = 0.01). The rates of sPTB <35 weeks were similar between each cohort: 24.3%, 23.0% and 27.7%, respectively (p = 0.81). BMI was not a predictor of any of the secondary outcomes. A HIC was placed in 47.2% and an UIC was placed in 52.8% women. Both unadjusted and adjusted analysis showed no significant difference in sPTB <35 weeks between BMI categories overall or by cerclage type (HIC or UIC).
Pre-pregnancy BMI is not a significant predictor of sPTB <35 weeks in women with HIC or UIC.
本研究旨在评估孕前体重指数（BMI）对宫颈环扎术成功率的影响。
对1994年至2011年间接受病史指征性（HIC）或超声指征性宫颈环扎术（UIC）的女性进行回顾性队列研究。根据孕前BMI（世界卫生组织标准），定义了三个队列：正常/超重（BMI：20.0 - 29.9 kg/m²）、I/II级肥胖（BMI：30.0 - 39.9 kg/m²）和III级肥胖（BMI≥40.0 kg/m²）。主要结局为孕35周前的自发性早产（sPTB）。次要结局包括但不限于分娩孕周、孕37周前、32周前、28周前的sPTB、胎膜早破和出生体重。
纳入375名女性进行分析。除黑人种族外（p = 0.01），三个BMI类别中的人口统计学特征相似。各队列中孕35周前的sPTB发生率相似：分别为24.3%、23.0%和27.7%（p = 0.81）。BMI不是任何次要结局的预测因素。47.2%的女性接受了HIC，52.
