Department of Gynaecology and Obstetrics, Liaocheng People's Hospital, Liaocheng, 252000, Shandong Province, People's Republic of China.
BMC Pregnancy Childbirth. 2018 Dec 27;18(1):509. doi: 10.1186/s12884-018-2151-0.
We examined the influence of pre-pregnancy body weight on the rates of attempted and successfully assisted-vaginal delivery.
We used 2008-2016 inpatient records including 3408 women who had singleton gestations and needed operative delivery assistance to conduct a retrospective cohort study. Patients were categorized based on pre-pregnancy BMI (normal weight = 18.5 to less than 25 or obese = 30 or greater). We used logistic regression to estimate odds ratios and 95% confidence intervals of attempted and successful forceps or vacuum-assisted vaginal delivery by body weight adjusted for marital status, age, gestational age, induction of labor, episiotomy, diabetes, and birth weight.
The proportion of women with attempted either vacuum or forceps was lower among women who were obese pre-pregnancy compared to women who were normal weight. Women with excessive gestational weight gain, large for gestational age neonates, and diabetes were less likely to have a vacuum-assisted or forceps-assisted vaginal delivery attempted. Conversely, women who received labor augmentation or induction, used epidural anesthesia, gained inadequate weight, and delivered a small for gestational age infant were more likely to have a vacuum-assisted or forceps-assisted vaginal delivery attempted. Compared to normal weight women, obese women who received forceps-assisted vaginal delivery were more likely to have a successful vaginal delivery.
Women who had normal weight had higher likelihood to attempt assisted vaginal delivery compared to women who had pre-pregnancy obesity. However, when assisted vaginal delivery was attempted, success rates were higher when forceps-assisted delivery was used compared to vacuum-assisted delivery.
我们研究了孕前体重对尝试和成功阴道助产率的影响。
我们使用了 2008 年至 2016 年的住院记录，包括 3408 名有单胎妊娠且需要手术分娩辅助的女性，进行了回顾性队列研究。患者根据孕前 BMI 进行分类（正常体重=18.5 至<25 或肥胖=30 或更高）。我们使用逻辑回归估计体重调整后的产钳或真空辅助阴道分娩的尝试和成功的比值比和 95%置信区间，调整的因素包括婚姻状况、年龄、孕龄、引产、会阴切开术、糖尿病和出生体重。
与正常体重的女性相比，孕前肥胖的女性尝试使用产钳或真空的比例较低。体重过度增加、巨大儿和糖尿病的女性更不可能尝试使用真空辅助或产钳辅助阴道分娩。相反，接受过分娩增强或引产、使用硬膜外麻醉、体重增加不足和分娩小于胎龄儿的女性更有可能尝试使用真空辅助或产钳辅助阴道分娩。与正常体重的女性相比，接受产钳辅助阴道分娩的肥胖女性更有可能成功进行阴道分娩。
与孕前肥胖的女性相比，正常体重的女性更有可能尝试阴道助产，但当尝试阴道助产时，使用产钳辅助分娩的成功率高于使用真空辅助分娩。
