McPherson Jessica A, Smid Marcela C, Smiley Sarah, Stamilio David M
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
Am J Perinatol. 2017 May;34(6):563-567. doi: 10.1055/s-0036-1594015. Epub 2016 Nov 17.
The primary aim of this study was to determine if there is an association between maternal obesity and cerebral palsy or death in children. This is a retrospective cohort analysis of a randomized controlled clinical trial previously performed by the Maternal-Fetal Medicine Units Network. Women in the original trial were included if at high risk for preterm delivery. The present study included singletons enrolled in the original study with complete data. Obese and nonobese women were compared. A secondary analysis comparing class 3 obese or classes 1 to 2 obese women to nonobese women was performed. The primary outcome was a composite of cerebral palsy or perinatal death. In this study, 1,261 nonobese, 339 obese, and 69 morbidly obese women were included. When adjusted for gestational age at delivery and magnesium exposure, there was no association between maternal obesity and child cerebral palsy or death. In the analysis using obesity severity categories, excess risk for adverse outcome appeared confined to the class 3 obese group. In women at high risk of delivering preterm, maternal obesity was not independently associated with child cerebral palsy or death. The association in unadjusted analysis appears to be mediated by preterm birth among obese patients.
本研究的主要目的是确定母亲肥胖与儿童脑瘫或死亡之间是否存在关联。这是对母胎医学单位网络先前进行的一项随机对照临床试验的回顾性队列分析。如果原试验中的女性有早产高风险，则纳入研究。本研究纳入了原研究中数据完整的单胎妊娠者。对肥胖和非肥胖女性进行了比较。还进行了一项二次分析，将3级肥胖或1至2级肥胖女性与非肥胖女性进行比较。主要结局是脑瘫或围产期死亡的综合情况。在本研究中，纳入了1261名非肥胖、339名肥胖和69名病态肥胖女性。在对分娩时的孕周和镁暴露进行调整后，母亲肥胖与儿童脑瘫或死亡之间没有关联。在使用肥胖严重程度分类的分析中，不良结局的额外风险似乎仅限于3级肥胖组。在有早产高风险的女性中，母亲肥胖与儿童脑瘫或死亡没有独立关联。未经调整分析中的关联似乎是由肥胖患者的早产所介导的。
