Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania.
Center for Research on Women and Gender, University of Illinois, Chicago, Illinois.
Am J Perinatol. 2018 Jul;35(9):844-851. doi: 10.1055/s-0037-1621733. Epub 2018 Jan 24.
The objective of this study was to describe the relationship between early pregnancy body mass index (BMI) and maternal, perinatal, and neonatal outcomes in rural India and Pakistan.
In a prospective, population-based pregnancy registry implemented in communities in Thatta, Pakistan and Nagpur and Belagavi, India, we obtained women's BMI prior to 12 weeks' gestation (categorized as underweight, normal, overweight, and obese following World Health Organization criteria). Outcomes were assessed 42 days postpartum.
The proportion of women with an adverse maternal outcome increased with increasing maternal BMI. Less than one-third of nonoverweight/nonobese women, 47.2% of overweight women, and 56.0% of obese women experienced an adverse maternal outcome. After controlling for site, maternal age and parity, risks of hypertensive disease/severe preeclampsia/eclampsia, cesarean/assisted delivery, and antibiotic use were higher among women with higher BMIs. Overweight women also had significantly higher risk of perinatal and early neonatal mortality compared with underweight/normal BMI women. Overweight women had a significantly higher perinatal mortality rate.
High BMI in early pregnancy was associated with increased risk of adverse maternal, perinatal, and neonatal outcomes in rural India and Pakistan. These findings present an opportunity to inform efforts for women to optimize weight prior to conception to improve pregnancy outcomes.
本研究旨在描述印度和巴基斯坦农村地区早期妊娠体重指数（BMI）与产妇、围产儿和新生儿结局之间的关系。
在巴基斯坦塔塔和印度那格浦尔和贝尔高姆社区实施的一项前瞻性、基于人群的妊娠登记研究中，我们在妊娠 12 周前获得了女性的 BMI（根据世界卫生组织标准归类为体重不足、正常、超重和肥胖）。在产后 42 天评估结局。
随着产妇 BMI 的增加，不良产妇结局的比例增加。不到三分之一的非超重/非肥胖女性、47.2%的超重女性和 56.0%的肥胖女性经历了不良产妇结局。在控制了地点、产妇年龄和产次后，BMI 较高的女性发生高血压疾病/重度子痫前期/子痫、剖宫产/辅助分娩和使用抗生素的风险较高。超重女性的围产儿和早期新生儿死亡率也明显高于体重不足/正常 BMI 的女性。超重女性的围产儿死亡率明显更高。
妊娠早期 BMI 较高与印度和巴基斯坦农村地区不良产妇、围产儿和新生儿结局的风险增加相关。这些发现为在妊娠前告知女性努力优化体重以改善妊娠结局提供了机会。
