Department of Epidemiology and Health Statistics, School of Public Health of Qingdao University, Qingdao, Shandong, China.
BJOG. 2018 Mar;125(4):407-413. doi: 10.1111/1471-0528.14841. Epub 2017 Sep 8.
Results from epidemiological studies about the association between maternal prepregnancy obesity and the risk of shoulder dystocia are inconsistent.
To evaluate the effect of maternal prepregnancy obesity on the risk of shoulder dystocia.
We searched PubMed and the Web of Science database for all relevant studies up to 5 August 2016 and reviewed the reference lists of identified articles.
Observational studies that investigated the association between prepregnancy obesity and the risk of shoulder dystocia were included.
A total of 20 articles involving 2 153 898 participants were included in this meta-analysis. A random-effects model was used to calculate the pooled relative risks (RRs) with 95% CIs.
For obese versus nonobese, the pooled RR of shoulder dystocia was 1.63 (95% CI: 1.33-1.99). The findings remained significant in the cohort studies (RR = 1.57, 95% CI: 1.28-1.93) and case-control studies (RR = 2.70, 95% CI: 1.46-4.98). With regard to the subgroup 'continents', there was a significant association between obesity and the risk of shoulder dystocia in Europe (RR = 1.51, 95% CI: 1.18-1.92) and Asia (RR = 2.59, 95% CI: 1.15-5.83). The result from the sensitivity analysis for studies adjusted for gestational diabetes was significant (RR = 1.61, 95% CI: 1.05-2.47). The pooled RRs for obesity classes I, II and III versus nonobese were 1.29 (95% CI: 1.06-1.57), 1.94 (95% CI: 1.26-2.98) and 2.47 (95% CI: 1.56-3.93), respectively.
This meta-analysis suggests that maternal prepregnancy obesity is associated with an increased risk of shoulder dystocia.
A meta-analysis shows that maternal prepregnancy obesity increases the risk of shoulder dystocia.
有关母体孕前肥胖与肩难产风险之间关联的流行病学研究结果并不一致。
评估母体孕前肥胖对肩难产风险的影响。
我们检索了 PubMed 和 Web of Science 数据库，检索时间截至 2016 年 8 月 5 日，查阅了确定文章的参考文献列表。
纳入了研究孕前肥胖与肩难产风险之间关联的观察性研究。
这项荟萃分析共纳入了 20 项研究，涉及 2153898 名参与者。采用随机效应模型计算合并的相对风险（RR）及其 95%置信区间（CI）。
对于肥胖与非肥胖者，肩难产的合并 RR 为 1.63（95%CI：1.33-1.99）。队列研究（RR=1.57，95%CI：1.28-1.93）和病例对照研究（RR=2.70，95%CI：1.46-4.98）中的结果仍然具有统计学意义。就“大陆”亚组而言，肥胖与肩难产风险之间存在显著关联，在欧洲（RR=1.51，95%CI：1.18-1.92）和亚洲（RR=2.59，95%CI：1.15-5.83）。对校正了妊娠期糖尿病的研究进行敏感性分析的结果具有统计学意义（RR=1.61，95%CI：1.05-2.47）。肥胖 I 级、II 级和 III 级与非肥胖者相比的 RR 分别为 1.29（95%CI：1.06-1.57）、1.94（95%CI：1.26-2.98）和 2.47（95%CI：1.56-3.93）。
这项荟萃分析表明，母体孕前肥胖与肩难产风险增加有关。
一项荟萃分析表明，母体孕前肥胖会增加肩难产的风险。
