Ornaghi Sara, Algeri Paola, Todyrenchuk Lyudmyla, Vertemati Emanuela, Vergani Patrizia
Department of Obstetrics and Gynecology, Foundation MBBM, University of Milan-Bicocca, via Pergolesi 33, 20900 Monza, Italy.
Department of Obstetrics and Gynecology, Foundation MBBM, University of Milan-Bicocca, via Pergolesi 33, 20900 Monza, Italy.
Pregnancy Hypertens. 2018 Apr;12:90-95. doi: 10.1016/j.preghy.2018.04.005. Epub 2018 Apr 10.
To investigate the effects of excessive pre-pregnancy body mass index (BMI) and abnormal gestational weight gain on adverse outcomes in women with chronic hypertension (CH).
A retrospective cohort study of CH women with singleton pregnancy delivered at our Institution in 2002-2013. Women were categorized as normal, overweight, and obese, according to their pre-pregnancy BMI. Further stratification was based on gestational weight gain (insufficient, adequate, and excessive) as defined by 2009 IOM guidelines.
Gestational diabetes, hypothyroidism, superimposed preeclampsia, preterm birth <37 weeks, cesarean section, and delivery of a small or large for gestational age neonate.
309 women met inclusion criteria. Obese women had increased odds of gestational diabetes (aOR, 3.18; 95% CI, 1.46-6.90), hypothyroidism (aOR, 2.41; 95% CI, 1.15-5.54), and superimposed preeclampsia (aOR, 2.36; 95% CI, 1.20-4.65), compared to normal BMI. Overweight women also displayed higher risk of diabetes (aOR 2.19; 95% CI, 1.05-5.03). Insufficient weight gain increased odds of small for gestational age neonate in normal BMI women (aOR, 1.82; 95% CI 1.31-2.07), whereas excessive gain was associated with superimposed preeclampsia in normal BMI patients (aOR, 3.51; 95% CI, 1.16-7.89) and with cesarean delivery in obese women (aOR, 2.96; 95% CI, 1.09-5.81).
Excessive pre-conception BMI and abnormal gestational weight gain increase odds of pregnancy complications in CH women. Our results stress the importance of pre-conception counseling for weight normalization in CH women, and support IOM recommendations for adequate weight gain during CH pregnancies.
探讨孕前体重指数（BMI）过高及孕期体重增加异常对慢性高血压（CH）女性不良结局的影响。
一项对2002年至2013年在我院分娩的单胎妊娠CH女性进行的回顾性队列研究。根据孕前BMI将女性分为正常、超重和肥胖。进一步分层基于2009年美国医学研究所（IOM）指南定义的孕期体重增加情况（不足、充足和过多）。
妊娠期糖尿病、甲状腺功能减退、子痫前期、孕周<37周的早产、剖宫产以及小于或大于胎龄儿的分娩。
309名女性符合纳入标准。与正常BMI女性相比，肥胖女性患妊娠期糖尿病（调整后比值比[aOR]，3.18；95%置信区间[CI]，1.46 - 6.90）、甲状腺功能减退（aOR，2.41；95% CI，1.15 - 5.54）和子痫前期（aOR，2.36；95% CI，1.20 - 4.65）的几率增加。超重女性患糖尿病的风险也更高（aOR 2.19；95% CI，1.05 - 5.03）。体重增加不足会增加正常BMI女性分娩小于胎龄儿的几率（aOR，1.82；95% CI 1.31 - 2.07），而体重增加过多与正常BMI患者患子痫前期（aOR，3.51；95% CI，1.16 - 7.89）以及肥胖女性剖宫产（aOR，2.96；95% CI，1.09 - 5.81）相关。
孕前BMI过高及孕期体重增加异常会增加CH女性妊娠并发症的几率。我们的结果强调了孕前咨询对CH女性体重正常化的重要性，并支持IOM关于CH妊娠期间适当体重增加的建议。
