Khalak Rubia, Rijhsinghani Asha, McCallum Sarah E
Department of Pediatrics/Neonatology Division, Albany Medical Center, Albany, New York, USA.
Department of Obstetrics and Gynecology/Division of Maternal-Fetal Medicine, Albany Medical Center, Albany, New York, USA.
Obesity (Silver Spring). 2017 May;25(5):945-949. doi: 10.1002/oby.21812. Epub 2017 Mar 22.
Infants born at less than 34 weeks' gestational age are at higher risk for morbidity and mortality. Data are limited on the impact of maternal obesity on the very preterm infant. This study reviewed whether maternal obesity further increases the intensive care needs of very preterm infants of less than 34 weeks' gestation.
Maternal and neonatal data for live-born singleton births of 23 0/7 to 33 6/7 weeks' gestation delivering in upstate New York were reviewed. BMI categorization followed the National Institutes of Health BMI classification that subdivides obesity into three ascending BMI groups.
Records were obtained on 1,224 women, of whom 31.6% were classified with obesity. Despite similar mean gestational age (31 to 31.6 weeks, P = 0.57) and birth weight (1,488 to 1,569 g, P = 0.51) of the infants in the BMI categories, delivery room (DR) resuscitation was more common for infants of women with level III obesity (63.2%, P = 0.04) with a trend toward the continued need for assisted ventilation (54.7%, P = 0.06).
Preterm infants of women with level III obesity were more likely to require DR resuscitation with a trend to continued need for ventilatory support beyond 6 hours of age. This could impact utilization of DR resources at delivering hospitals.
孕龄小于34周出生的婴儿发病和死亡风险更高。关于母亲肥胖对极早产儿的影响的数据有限。本研究回顾了母亲肥胖是否会进一步增加孕龄小于34周的极早产儿的重症监护需求。
回顾了在纽约州北部分娩的孕龄为23 0/7至33 6/7周的单胎活产的母亲和新生儿数据。BMI分类遵循美国国立卫生研究院的BMI分类，该分类将肥胖细分为三个BMI递增组。
获取了1224名女性的记录，其中31.6%被归类为肥胖。尽管不同BMI类别中的婴儿平均孕龄相似（31至31.6周，P = 0.57）且出生体重相似（1488至1569克，P = 0.51），但III级肥胖女性的婴儿在产房（DR）进行复苏更为常见（63.2%，P = 0.04），且有持续需要辅助通气的趋势（54.7%，P = 0.06）。
III级肥胖女性的早产儿更有可能需要产房复苏，且有在6小时龄后持续需要通气支持的趋势。这可能会影响分娩医院产房资源的利用。
