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一家三级转诊中心的孕产妇肥胖与产科结局

Maternal obesity and obstetric outcomes in a tertiary referral center.

作者信息

Ramonienė Gitana, Maleckienė Laima, Nadišauskienė Rūta Jolanta, Bartusevičienė Eglė, Railaitė Dalia Regina, Mačiulevičienė Regina, Maleckas Almantas

机构信息

Department of Obstetrics and Gynecology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Department of Obstetrics and Gynecology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2017;53(2):109-113. doi: 10.1016/j.medici.2017.03.003. Epub 2017 Apr 19.

Abstract

BACKGROUND AND AIM

Obese women are at an increased risk of various adverse pregnancy outcomes. The aim of our study was to evaluate the impact of obesity on maternal and neonatal outcomes in a tertiary referral center and to compare obstetric outcomes by the level of maternal obesity.

MATERIALS AND METHODS

A cohort study included 3247 women with singleton gestations who gave birth at the Department of Obstetrics and Gynecology, Lithuanian University of Health Sciences, in 2010. Pregnancy complications and neonatal outcomes were identified using the hospital Birth Registry database in normal weight (body mass index [BMI] 18.5-24.9kg/m, n=3107) and prepregnancy obese (BMI ≥30kg/m, n=140) women. Pregnancy outcomes were compared according to the level of obesity (BMI 30-34.9kg/m, n=94 and BMI ≥35kg/m, n=46).

RESULTS

Obese women were significantly more likely to have gestational hypertension (OR=8.59; 95% CI, 5.23-14.14; P<0.0001), preeclampsia (OR=2.06; 95% CI, 1.14-3.73; P<0.0001), gestational diabetes (OR=5.56; 95% CI, 3.66-8.49; P<0.0001), dystocia (OR=2.14; 95% CI, 1.36-3.38; P<0.0001), induced labor (OR=2.64; 95% CI, 1.83-3.80; P<0.0001), failed induction of labor (OR=18.06; 95% CI, 8.85-36.84; P<0.0001), cesarean delivery (OR=1.76; 95% CI, 1.25-2.49; P=0.001), large-for-gestational-age newborns (OR=3.68; 95% CI, 2.51-5.39; P<0.0001). Significantly increased risk of gestational diabetes, preeclampsia, dystocia and newborns with Apgar score ≤7 after 5min was only observed in women with BMI ≥35kg/m.

CONCLUSIONS

Maternal obesity is significantly associated with an increased risk of gestational hypertension, preeclampsia, gestational diabetes, dystocia, labor induction, failed induction of labor, large-for-gestational-age newborns and cesarean delivery.

摘要

背景与目的

肥胖女性出现各种不良妊娠结局的风险增加。我们研究的目的是评估肥胖对一家三级转诊中心孕产妇和新生儿结局的影响,并根据孕产妇肥胖程度比较产科结局。

材料与方法

一项队列研究纳入了2010年在立陶宛卫生科学大学妇产科分娩的3247名单胎妊娠女性。利用医院出生登记数据库确定正常体重(体重指数[BMI]18.5 - 24.9kg/m²,n = 3107)和孕前肥胖(BMI≥30kg/m²,n = 140)女性的妊娠并发症和新生儿结局。根据肥胖程度(BMI 30 - 34.9kg/m²,n = 94和BMI≥35kg/m²,n = 46)比较妊娠结局。

结果

肥胖女性发生妊娠期高血压(比值比[OR]=8.59;95%置信区间[CI],5.23 - 14.14;P<0.0001)、子痫前期(OR = 2.06;95%CI,1.14 - 3.73;P<0.0001)、妊娠期糖尿病(OR = 5.56;95%CI,3.66 - 8.49;P<0.0001)、难产(OR = 2.14;95%CI,1.36 - 3.38;P<0.0001)、引产(OR = 2.64;95%CI,1.83 - 3.80;P<0.0001)、引产失败(OR = 18.06;95%CI,8.85 - 36.84;P<0.0001)、剖宫产(OR = 1.76;95%CI,1.25 - 2.49;P = 0.001)、大于胎龄儿(OR = 3.68;95%CI,2.51 - 5.39;P<0.0001)的可能性显著更高。仅在BMI≥35kg/m²的女性中观察到妊娠期糖尿病、子痫前期、难产和5分钟后阿氏评分≤7分新生儿的风险显著增加。

结论

孕产妇肥胖与妊娠期高血压、子痫前期、妊娠期糖尿病、难产、引产、引产失败、大于胎龄儿和剖宫产的风险增加显著相关。

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