Vinturache Angela E, Chaput Kathleen H, Tough Suzanne C
a Department of Paediatrics , Cumming School of Medicine, University of Calgary , Calgary , Alberta , Canada and.
b Departments of Pediatrics and Community Health Sciences , Cumming School of Medicine, University of Calgary , Calgary , Alberta , Canada.
J Matern Fetal Neonatal Med. 2017 Jan;30(1):109-116. doi: 10.3109/14767058.2016.1163679. Epub 2016 Apr 6.
To compare demographic characteristics and maternal, fetal, neonatal, and pregnancy outcomes of term macrosomic infants of obese and non-obese mothers.
A sample of 1996 singleton, term deliveries was drawn from the All Our Babies Cohort, a prospective, community-based pregnancy cohort. Maternal self-reported socio-demographic and anthropometric information was linked to the clinical data on pregnancy and birth events abstracted from electronic health records. Demographic, obstetrical characteristics and maternal, fetal, neonatal, and pregnancy outcomes of macrosomic infants in obese, overweight, and normal weight women were compared. Multinomial regression analysis assessed the risk factors of macrosomia in primiparous and multiparous women stratified by maternal pre-pregnancy BMI, controlling for confounding variables.
Macrosomia affected 10% of pregnancies in the study. Mothers whose infants were macrosomic were more likely to be Caucasian, obese, have had previous deliveries, undergo induction of labour and delivery by emergency C-section, particularly for labour abnormalities. Macrosomic infants were more likely to be delivered postdates, have meconium stained liquor and require resuscitation at birth. There were no significant differences in birth and neonatal outcomes of macrosomic pregnancies between obese, overweight and normal weight women. Pre-pregnancy BMI and gestational age at delivery were risk factors for macrosomia in all women. Ethnicity and history of delivery of a macrosomic infant were additional independent risk factors in multiparas.
Obesity in pregnancy increases the risk of delivery of a macrosomic infant in both primiparous and multiparous women. The maternal, fetal and neonatal outcomes of macrosomic pregnancies are similar in obese and normal weight women.
比较肥胖与非肥胖母亲足月巨大儿的人口统计学特征以及母亲、胎儿、新生儿和妊娠结局。
从“我们所有的婴儿队列”（一个基于社区的前瞻性妊娠队列）中抽取1996例单胎足月分娩样本。母亲自我报告的社会人口统计学和人体测量学信息与从电子健康记录中提取的妊娠和分娩事件的临床数据相关联。比较肥胖、超重和正常体重女性中巨大儿的人口统计学、产科特征以及母亲、胎儿、新生儿和妊娠结局。多项回归分析评估了初产妇和经产妇中按孕前体重指数分层的巨大儿风险因素，并对混杂变量进行了控制。
巨大儿影响了研究中10%的妊娠。其婴儿为巨大儿的母亲更可能是白种人、肥胖、有过既往分娩史、接受引产以及急诊剖宫产分娩，尤其是因产程异常。巨大儿更可能过期产、羊水粪染且出生时需要复苏。肥胖、超重和正常体重女性中巨大儿妊娠的出生和新生儿结局无显著差异。孕前体重指数和分娩时的孕周是所有女性巨大儿的风险因素。种族和巨大儿分娩史是经产妇额外的独立风险因素。
孕期肥胖增加了初产妇和经产妇分娩巨大儿的风险。肥胖和正常体重女性中巨大儿妊娠的母亲、胎儿和新生儿结局相似。
