Department of Anaesthesia and Perioperative Medicine, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; The University of Queensland, St Lucia, Queensland, Australia.
Department of Anaesthesia and Perioperative Medicine, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; The University of Queensland, St Lucia, Queensland, Australia.
Int J Obstet Anesth. 2019 May;38:59-65. doi: 10.1016/j.ijoa.2018.10.005. Epub 2018 Oct 19.
Body mass index does not indicate the distribution of adipose tissue. Central adiposity may be measured using ultrasound measurement of subcutaneous fat thickness. This study determined if the abdominal subcutaneous fat thickness measured correlated with skin-to-epidural space distance at delivery, and compared this with the booking body mass index.
We analysed a sub-set of participants from a single-centre, prospective cohort study that assessed the relationship between subcutaneous fat thickness and maternity outcomes. Abdominal subcutaneous fat thickness measurements were obtained during the routine fetal anomaly scan. The skin-to-epidural space distance was obtained in those having epidural or combined spinal-epidural analgesia. Linear regression was used to test for strength of association and adjusted R values calculated to determine if subcutaneous fat thickness or body mass index was more strongly associated with skin-to-epidural space distance.
The 463 women had a median (IQR) booking body mass index of 25.0 kg/m (21.8-29.3) and subcutaneous fat thickness of 16.2 mm (13.0-21.0). The median (IQR) skin-to-epidural space distance was 5.0 cm (4.5-6.0). Both parameters significantly correlated with skin-to-epidural space distance (r=0.53 and 0.68 respectively, P <0.001). Adjusted linear regression coefficient (95% CI) for subcutaneous fat thickness was 0.09 (0.08 to 0.11), R=0.30 and for body mass index 0.12 (0.11 to 0.13), R=0.47.
Booking body mass index had a stronger relationship with skin-to- epidural space distance at delivery than subcutaneous fat thickness, explaining 47% of the variation in the skin-to-epidural distance.
体重指数不能反映脂肪组织的分布。体脂过多可通过超声测量皮下脂肪厚度来测量。本研究旨在确定分娩时测量的腹部皮下脂肪厚度与硬膜外间隙距离是否相关，并与预订的体重指数进行比较。
我们分析了一项单中心前瞻性队列研究的子样本，该研究评估了皮下脂肪厚度与产妇结局之间的关系。在常规胎儿畸形扫描期间获得腹部皮下脂肪厚度测量值。在接受硬膜外或联合脊髓-硬膜外镇痛的患者中获得皮肤到硬膜外空间距离。使用线性回归测试关联强度，并计算调整后的 R 值以确定皮下脂肪厚度或体重指数与皮肤到硬膜外空间距离的关联是否更强。
463 名女性的预订体重指数中位数（IQR）为 25.0kg/m2（21.8-29.3），皮下脂肪厚度中位数（IQR）为 16.2mm（13.0-21.0）。皮肤到硬膜外空间距离的中位数（IQR）为 5.0cm（4.5-6.0）。两个参数与皮肤到硬膜外空间距离均显著相关（r分别为 0.53 和 0.68，P<0.001）。调整后的线性回归系数（95%CI）为皮下脂肪厚度 0.09（0.08-0.11），R2=0.30，体重指数 0.12（0.11-0.13），R2=0.47。
与皮下脂肪厚度相比，预订的体重指数与分娩时皮肤到硬膜外空间距离的关系更强，解释了皮肤到硬膜外距离变化的 47%。
