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孕前BMI正常的女性孕期体重增加对剖宫产风险、围产期出生体重和孕周的影响

Impact of Gestational Weight Gain on Cesarean Delivery Risk, Perinatal Birth Weight and Gestational Age in Women with Normal Pre-pregnancy BMI.

作者信息

Omani-Samani Reza, Sepidarkish Mahdi, Safiri Saeid, Esmailzadeh Arezoo, Vesali Samira, Farzaneh Farahnaz, Almasi-Hashiani Amir

机构信息

1Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Royan Institute, Bani Hashem Place, Hafez St., P.O. Box: 16635148, Tehran, Iran.

2Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran.

出版信息

J Obstet Gynaecol India. 2018 Aug;68(4):258-263. doi: 10.1007/s13224-017-1023-2. Epub 2017 Jun 15.

Abstract

BACKGROUND

Gestational weight gain (GWG) proportional to body mass index before pregnancy is one of the factors on maternal and neonatal outcomes. The aim of the current study was to assess association between GWG, and cesarean section, birth weight and gestational age at birth in women with normal BMI prior to pregnancy.

METHODS

This was a cross-sectional study carried out in 103 hospitals in Tehran, the capital of Iran, from July 6 to 21, 2015. The data were extracted by 103 trained midwives. Finally, 2394 pregnant women with normal BMI before pregnancy and singleton birth were examined. GWG was categorized based on Institute of Medicine (IOM) recommendations.

RESULTS

Prevalence of low birth weight (LBW) was 5.41% and prevalence of macrosomia was 2.18%. The prevalence of LBW in women with GWG less than the weight gain recommended by IOM was 2.13 times [95% confidence interval (CI) 1.13-4.02,  = 0.019] more than in women with GWG equal to the weight gain recommended by IOM. There was no statistically significant difference in the prevalence of LBW between women with GWG more than recommended weight gain by IOM and women with GWG equal to the weight gain recommended by IOM (OR = 1.21, 95% CI 0.61-2.38,  = 0.580).

CONCLUSION

After controlling for confounding variables, the prevalence of cesarean section and preterm birth had no significant difference at various levels of GWG. Accordingly, the prevalence of LBW among women with GWG less than the recommended weight gain by IOM was significantly 2.13 more than that among women with GWG equal to the recommended weight gain by IOM.

摘要

背景

孕期体重增加(GWG)与孕前体重指数成正比是影响母婴结局的因素之一。本研究的目的是评估孕前体重指数正常的女性中,GWG与剖宫产、出生体重和出生孕周之间的关联。

方法

这是一项于2015年7月6日至21日在伊朗首都德黑兰的103家医院开展的横断面研究。数据由103名经过培训的助产士提取。最终,对2394名孕前体重指数正常且为单胎分娩的孕妇进行了检查。GWG根据美国医学研究所(IOM)的建议进行分类。

结果

低出生体重(LBW)的患病率为5.41%,巨大儿的患病率为2.18%。GWG低于IOM建议体重增加量的女性中LBW的患病率是GWG等于IOM建议体重增加量的女性的2.13倍[95%置信区间(CI)1.13 - 4.02,P = 0.019]。GWG高于IOM建议体重增加量的女性与GWG等于IOM建议体重增加量的女性相比,LBW患病率无统计学显著差异(OR = 1.21,95% CI 0.61 - 2.38,P = 0.580)。

结论

在控制混杂变量后,不同GWG水平下剖宫产和早产的患病率无显著差异。因此,GWG低于IOM建议体重增加量的女性中LBW的患病率显著高于GWG等于IOM建议体重增加量的女性,前者是后者的2.13倍。

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Determinants of cesarean delivery: a classification tree analysis.剖宫产的决定因素:一项分类树分析
BMC Pregnancy Childbirth. 2014 Jun 28;14:215. doi: 10.1186/1471-2393-14-215.

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