Kennedy N J, Peek M J, Quinton A E, Lanzarone V, Martin A, Benzie R, Nanan R
Discipline of Obstetrics, Gynaecology and Neonatology, Sydney Medical School Nepean, Nepean Hospital, University of Sydney, Penrith, NSW, Australia.
Christopher Kohlenberg Department of Perinatal Ultrasound, Nepean Hospital, Penrith, NSW, Australia.
BJOG. 2016 Jan;123(2):225-32. doi: 10.1111/1471-0528.13758.
To assess maternal abdominal subcutaneous fat thickness (SFT) measured by ultrasound as an independent predictor of adverse pregnancy outcomes.
A prospective longitudinal cohort study performed on pregnancies delivered between 2012 and 2014.
Sydney, Australia.
About 1510 pregnant women attending routine obstetric ultrasounds.
Maternal SFT was measured on routine ultrasounds at 11-14 weeks' gestation (SFT1) and 18-22 weeks' gestation (SFT2). SFT measurements were assessed for estimating risks for obesity-related pregnancy outcomes using logistic regression modelling adjusted for maternal age, parity, smoking status and body mass index (BMI).
Hypertensive disease, gestational diabetes, caesarean section, low birthweight, preterm delivery, neonatal respiratory distress, Apgar scores, and admission to a neonatal intensive care unit.
SFT1 and SFT2 were measured on 1461 and 1363 women, respectively. Mean thickness (range) were 21.2 mm (6.9-73.9) for SFT1 and 20.3 mm (7.5-68.0) for SFT2. Complete outcome data were available for 1385 pregnancies. In all, 54% of the women were overweight/obese. The SFT measures decreased from early to mid-pregnancy in overweight/obese women. There was moderate correlation between BMI and SFT1 (R(2) = 0.56) and BMI and SFT2 (R(2) = 0.55). In a multivariate model, SFT1 and SFT2 were better predictors for adverse pregnancy outcomes than BMI.
Maternal SFT is a significant independent predictor of adverse pregnancy outcomes. Incorporation of SFT into future models for adverse pregnancy outcome may prove valuable.
评估通过超声测量的孕妇腹部皮下脂肪厚度（SFT）作为不良妊娠结局的独立预测指标。
对2012年至2014年期间分娩的孕妇进行的一项前瞻性纵向队列研究。
澳大利亚悉尼。
约1510名接受常规产科超声检查的孕妇。
在妊娠11 - 14周（SFT1）和18 - 22周（SFT2）的常规超声检查中测量孕妇的SFT。使用针对孕妇年龄、产次、吸烟状况和体重指数（BMI）进行调整的逻辑回归模型，评估SFT测量值以估计肥胖相关妊娠结局的风险。
高血压疾病、妊娠期糖尿病、剖宫产、低出生体重、早产、新生儿呼吸窘迫、阿氏评分以及入住新生儿重症监护病房。
分别对1461名和1363名女性测量了SFT1和SFT2。SFT1的平均厚度（范围）为21.2毫米（6.9 - 73.9），SFT2为20.3毫米（7.5 - 68.0）。有1385例妊娠的完整结局数据。总体而言，54%的女性超重/肥胖。超重/肥胖女性的SFT测量值从孕早期到孕中期有所下降。BMI与SFT1（R² = 0.56）以及BMI与SFT2（R² = 0.55）之间存在中度相关性。在多变量模型中，SFT1和SFT2比BMI更能预测不良妊娠结局。
孕妇SFT是不良妊娠结局的重要独立预测指标。将SFT纳入未来不良妊娠结局模型可能具有重要价值。
