体重指数对引产的影响：一项历史性队列研究。

Influence of body mass index on induction of labor: A historical cohort study.

作者信息

Dammer Ulf, Bogner Roswitha, Weiss Christel, Faschingbauer Florian, Pretscher Jutta, Beckmann Matthias W, Sütterlin Marc, Kehl Sven

机构信息

Department of Obstetrics and Gynaecology, Erlangen University Hospital, Erlangen, Germany.

Department of Medical Statistics and Biomathematics, University Medical Centre Mannheim, Heidelberg University, Heidelberg, Germany.

出版信息

J Obstet Gynaecol Res. 2018 Apr;44(4):697-707. doi: 10.1111/jog.13561. Epub 2018 Jan 8.

DOI:10.1111/jog.13561

PMID:29316054

Abstract

AIM

We aimed to determine the influence of body mass index (BMI) on induction of labor.

METHODS

In this historical multicenter cohort study, 2122 labor inductions were analyzed. Women were divided into four groups according to their body mass index (BMI): BMI < 30 (normal group [NG]), 30 ≤ BMI < 35 (group 1 [G1]), 35 ≤ BMI < 40 (group 2 [G2]), and BMI ≥ 40 (group 3 [G3]). The primary outcome measure was the induction-to-delivery interval. The secondary outcome parameter was, among others, the rate of cesarean section.

RESULTS

A total of 1113 inductions of labor were analyzed in the NG, 610 in G1, 239 in G2, and 160 in G3. The induction-to-delivery interval was shorter in the NG compared to G1 (mean values 1550 min vs 1669 min, P = 0.0406), G2 (1745 min, P = 0.0294), and G3 (1899 min, P = 0.0008). The cesarean section rate was significantly higher in G1-G3 (G1: 30.8%, P < 0.001; G2: 30.5%, P < 0.0067; G3: 42.5%, P < 0.0001) compared to the NG (21.8%). There were more vaginal deliveries within 48 h in the NG (84%) compared to G1-G3 (78%, P = 0.0186; 75%, P = 0.0049; 75%, P = 0.0329). However, these findings could mainly be seen in nulliparous women when stratifying for parity. Multivariable analysis showed that high BMI increased the induction-to-delivery interval whereas high parity, gestational age, and Bishop score decreased it.

CONCLUSION

An increased body mass index has a negative impact on induction of labor at term, especially in nulliparous women.

摘要

目的

我们旨在确定体重指数（BMI）对引产的影响。

方法

在这项历史性多中心队列研究中，分析了2122例引产情况。根据体重指数（BMI）将女性分为四组：BMI＜30（正常组[NG]），30≤BMI＜35（第1组[G1]），35≤BMI＜40（第2组[G2]），以及BMI≥40（第3组[G3]）。主要结局指标是引产至分娩间隔。次要结局参数包括剖宫产率等。

结果

NG组共分析了1113例引产，G1组610例，G2组239例，G3组160例。与G1组（平均值1550分钟对1669分钟，P = 0.0406）、G2组（1745分钟，P = 0.0294）和G3组（1899分钟，P = 0.0008）相比，NG组的引产至分娩间隔更短。与NG组（21.8%）相比，G1 - G3组的剖宫产率显著更高（G1组：30.8%，P＜0.001；G2组：30.5%，P＜0.0067；G3组：42.5%，P＜0.0001）。与G1 - G3组（78%，P = 0.0186；75%，P = 0.0049；75%，P = 0.0329）相比，NG组在48小时内阴道分娩的比例更高（84%）。然而，在按产次分层时，这些发现主要见于初产妇。多变量分析显示，高BMI会增加引产至分娩间隔，而高胎次、孕周和Bishop评分则会降低该间隔。