Lamminpää Reeta, Vehviläinen-Julkunen Katri, Gissler Mika, Selander Tuomas, Heinonen Seppo
Department of Nursing Science, University of Eastern Finland, P.O. Box. 1627, 70211 Kuopio, Finland.
Department of Nursing Science, University of Eastern Finland, P.O. Box. 1627, 70211 Kuopio, Finland; Kuopio University Hospital, Kuopio, Finland.
Obes Res Clin Pract. 2016 Mar-Apr;10(2):133-42. doi: 10.1016/j.orcp.2015.05.008. Epub 2015 Jun 6.
To compare pregnancy outcomes of overweight and obese pregnant women aged 35 years or older to women aged less than 35 years old.
A registry-based study covering years 2004-2008 including data on women ≥35 years (N=45,718) compared to those <35 years (N=203,930) and their pre-pregnancy body mass index (BMI) (<25, 25-29 and ≥30). In multivariable modelling, the main outcome measures were preterm delivery (<28 weeks, 28-31weeks and 32-36 weeks), low Apgar scores at 5min, small-for-gestational age (SGA), foetal death, asphyxia, Caesarean section, induction, preeclampsia, blood transfusion, admission to a neonatal intensive care unit (NICU), shoulder dystocia, and large for gestational age (LGA).
Maternal overweight and obesity along with advanced maternal age (AMA) significantly increased the risks of preterm delivery, preeclampsia, foetal death, LGA and Caesarean as compared to women of average weight aged <35 years. When comparing overweight and obese women aged ≥35 years to normal weight women of the same age, the rates of preeclampsia, preterm delivery <28 weeks, LGA and low Apgar score were significantly increased. When observing overweight and obese women <35 years as a reference group, the risks of preterm delivery and foetal death were significantly increased.
The risks were increased by maternal age≥35 years and both obesity and overweight. The combined effect of AMA and either overweight or obesity appeared to be a high risk state particularly for stillbirth and preterm delivery.
比较35岁及以上超重和肥胖孕妇与年龄小于35岁孕妇的妊娠结局。
一项基于登记处的研究，涵盖2004年至2008年的数据，包括年龄≥35岁的女性（N = 45,718）与年龄<35岁的女性（N = 203,930）及其孕前体重指数（BMI）（<25、25 - 29和≥30）。在多变量建模中，主要结局指标包括早产（<28周、28 - 31周和32 - 36周）、5分钟时阿氏评分低、小于胎龄儿（SGA）、胎儿死亡、窒息、剖宫产、引产、先兆子痫、输血、入住新生儿重症监护病房（NICU）、肩难产和大于胎龄儿（LGA）。
与年龄小于35岁的平均体重女性相比，孕妇超重和肥胖以及高龄产妇（AMA）显著增加了早产、先兆子痫、胎儿死亡、LGA和剖宫产的风险。将年龄≥35岁的超重和肥胖女性与同年龄的正常体重女性进行比较时，先兆子痫、<28周早产、LGA和低阿氏评分的发生率显著增加。将年龄<35岁的超重和肥胖女性作为参照组观察时，早产和胎儿死亡的风险显著增加。
母亲年龄≥35岁以及肥胖和超重都会增加风险。AMA与超重或肥胖的联合作用似乎是一种高风险状态，尤其是对于死产和早产。
