Fernández Alba Juan Jesús, Paublete Herrera Carmen, Vilar Sanchez Angel, Gonzalez-Macias Carmen, Castillo Lara Maria, Torrejón Rafael, Moreno Corral Luis Javier
a Hospital Universitario de Puerto Real, Obstetricia y Ginecología , El Puerto de Santa María (Valdelagrana) , Algodonales , Spain.
b Enfermería y Fisioterapia , Universidad de Cadiz , Cadiz , Spain.
J Matern Fetal Neonatal Med. 2018 Feb;31(3):357-363. doi: 10.1080/14767058.2017.1285894. Epub 2017 Feb 14.
The aim of this study was to test the hypothesis that indications of c-section in overweight or obese pregnant women are different from those with normal-weight.
Retrospective cohort study at University Hospital of Puerto Real (Cádiz-Spain). We compared frequency distribution of c-section indications in overweight and obese versus normal-weight. The risk of c-section by different indications was calculated as relative risk.
A total of 4685 births were included in the study. There are significant differences in the frequency distribution of caesarean indications among normal weight and overweight or obese women. In overweight, we found an increased risk of c-section due to previous c-section (RR: 1.73; confidence interval [CI] 95% 1.24-2.42), obstructed/non-progressive labour (RR: 1.34; CI 95% 1.03-1.75), failed induction of labour (RR: 2.38; CI 95% 1.30-4.34) and foetal distress (RR: 1.73; CI 95% 1.21-2.49). This risk was even higher in obese women: previous c-section (RR: 3.25; CI 95% 2.24-4.71), obstructed/non-progressive labour (RR: 2; CI 95% 1.45-2.77), failed induction (RR: 2.52; CI 95% 1.15-5.51) and foetal distress (RR: 2.35; CI 95% 1.51-3.65).
The risk of caesarean section due to previous caesarean section, obstructed/non-progressive labour, failed induction of labour or foetal distress is greater in overweight and obese than in normal-weight. This increase in risk also increases progressively as maternal BMI increases.
本研究的目的是检验超重或肥胖孕妇剖宫产指征与体重正常孕妇不同这一假设。
在西班牙加的斯市雷亚尔港大学医院进行回顾性队列研究。我们比较了超重和肥胖孕妇与体重正常孕妇剖宫产指征的频率分布。不同指征的剖宫产风险以相对风险计算。
本研究共纳入4685例分娩。正常体重、超重或肥胖女性剖宫产指征的频率分布存在显著差异。超重孕妇中，因既往剖宫产（相对风险：1.73；95%置信区间1.24 - 2.42）、产程梗阻/无进展（相对风险：1.34；95%置信区间1.03 - 1.75）、引产失败（相对风险：2.38；95%置信区间1.30 - 4.34）和胎儿窘迫（相对风险：1.73；95%置信区间1.21 - 2.49）导致剖宫产的风险增加。肥胖女性的这种风险更高：既往剖宫产（相对风险：3.25；95%置信区间2.24 - 4.71）、产程梗阻/无进展（相对风险：2；95%置信区间1.45 - 2.77）、引产失败（相对风险：2.52；95%置信区间1.15 - 5.51）和胎儿窘迫（相对风险：2.35；95%置信区间1.51 - 3.65）。
超重和肥胖孕妇因既往剖宫产、产程梗阻/无进展、引产失败或胎儿窘迫进行剖宫产的风险高于体重正常孕妇。随着孕妇体重指数增加，这种风险增加也逐渐加剧。
