母亲超重和肥胖会增加分娩过程中胎儿酸中毒的风险。
Maternal overweight and obesity increase the risk of fetal acidosis during labor.
机构信息
Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
出版信息
J Perinatol. 2018 Sep;38(9):1144-1150. doi: 10.1038/s41372-018-0144-5. Epub 2018 Jun 19.
OBJECTIVE
To investigate whether maternal overweight and obesity increased the risk of fetal acidosis measured in umbilical cord arterial blood after delivery.
STUDY DESIGN
Population-based cohort study of 84,785 term (≥37 weeks) infants. Logistic regression was used to estimate risks of fetal acidosis in umbilical cord arterial blood. Fetal acidosis was defined as pH <7.10 or as pH <1st percentile on a normal reference curve.
RESULT
Risks of fetal acidosis increased, regardless of definition, with maternal overweight and obesity severity. Compared to normal weight (BMI 18.5-<25), the odds ratios (95% confidence interval) for pH <7.10 were 1.35 (1.23-1.47) for overweight (BMI 25-<30), 1.46 (1.27-1.69) for mild obesity (BMI 30-<35), and 1.75 (1.42-2.15) for severe obesity (BMI ≥35). The association for obesity was attenuated in analyses restricted to non-instrumental vaginal deliveries.
CONCLUSION
Maternal overweight and obesity increased the risk of fetal acidosis. More complicated deliveries in obese women may partially explain this association.
目的
探讨分娩后脐带动脉血中胎儿酸中毒的风险是否与母亲超重和肥胖有关。
研究设计
对 84785 例足月（≥37 周）婴儿进行基于人群的队列研究。采用 logistic 回归估计脐带动脉血中胎儿酸中毒的风险。胎儿酸中毒定义为 pH 值<7.10 或正常参考曲线下第 1 百分位的 pH 值。
结果
无论采用哪种定义，随着母亲超重和肥胖程度的加重，胎儿酸中毒的风险均增加。与正常体重（BMI 18.5-<25）相比，超重（BMI 25-<30）、轻度肥胖（BMI 30-<35）和重度肥胖（BMI ≥35）的 pH 值<7.10 的比值比（95%置信区间）分别为 1.35（1.23-1.47）、1.46（1.27-1.69）和 1.75（1.42-2.15）。在仅包括非器械性阴道分娩的分析中，肥胖与胎儿酸中毒之间的关联减弱。
结论
母亲超重和肥胖会增加胎儿酸中毒的风险。肥胖妇女分娩过程更复杂可能部分解释了这种关联。
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