Little Jessica, Nugent Rachael, Vangaveti Venkat
Department of Obstetrics & Gynaecology, Logan Hospital, Meadowbrook, Queensland, Australia.
Department of Obstetrics & Gynaecology, Mackay Base Hospital, Mackay, Queensland, Australia.
Aust N Z J Obstet Gynaecol. 2019 Apr;59(2):243-250. doi: 10.1111/ajo.12830. Epub 2018 May 23.
Maternal obesity is a growing health concern that has previously been associated with increased need for induction of labour (IOL) and caesarean section (CS) rates. Currently, limited evidence explores the influence of maternal body mass index (BMI) on Bishop Score (BS) and outcome of IOL. This study hypothesises that maternal obesity will lead to a lower BS at presentation, higher rates of failed IOL, and increased CS rates.
To explore the influence of maternal obesity on BS and likelihood of failed IOL.
A retrospective cohort analysis was conducted of all live, term, singleton, cephalic deliveries initiated with IOL across normal BMI (18.00-24.99), overweight BMI (25.00-29.99), and obese BMI (>30.00) at the Townsville Hospital and Health Service (THHS) between July 2011 to June 2016. Student's t-test, χ test, and binary logistic regression were used for statistical analysis. BS and failed IOL, defined as CS with cervical dilatation <3 cm, were the primary outcome measures. Delivery mode was the secondary outcome measure.
A total of 1543 women were included, 678 with normal BMI, 370 with overweight BMI, and 495 with obese BMI. Obese women are more likely to have a low BS (<5) at presentation (unadjusted odds ratio (OR) 1.5 (1.1-2.0), P < 0.05), an increased rate of failed IOL (adjusted OR (aOR) 1.6 (1.0-2.5), P < 0.05) and increased CS rate (aOR 1.1 (1.0-1.9), P < 0.05), compared to normal weight women.
Maternal obesity is associated with a lower BS, more difficult IOL process, and increased risk of failed IOL and CS.
孕妇肥胖是一个日益严重的健康问题，此前一直与引产（IOL）需求增加和剖宫产（CS）率上升有关。目前，关于孕妇体重指数（BMI）对Bishop评分（BS）和IOL结局影响的证据有限。本研究假设孕妇肥胖会导致入院时BS较低、IOL失败率较高以及CS率增加。
探讨孕妇肥胖对BS和IOL失败可能性的影响。
对2011年7月至2016年6月在汤斯维尔医院及卫生服务中心（THHS）进行的所有以IOL开始的足月、单胎、头位活产进行回顾性队列分析，这些孕妇的BMI正常（18.00 - 24.99）、超重（25.00 - 29.99）和肥胖（>30.00）。采用学生t检验、χ检验和二元逻辑回归进行统计分析。主要结局指标为BS和IOL失败（定义为宫颈扩张<3 cm时行剖宫产）。分娩方式为次要结局指标。
共纳入1543名女性，678名BMI正常，370名超重，495名肥胖。与体重正常的女性相比，肥胖女性入院时BS较低（<5）的可能性更大（未调整优势比（OR）为1.5（1.1 - 2.0），P < 0.05），IOL失败率增加（调整后OR（aOR）为1.6（1.0 - 2.5），P < 0.05），CS率增加（aOR为1.1（1.0 - 1.9），P < 0.05）。
孕妇肥胖与较低的BS、更困难的IOL过程以及IOL失败和CS风险增加有关。
Zotero 插件