Ferrazzi Enrico, Brembilla Gloria, Cipriani Sonia, Livio Stefania, Paganelli Andrea, Parazzini Fabio
Department of Obstetrics and Gynaecology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, EU, Italy; Dept of Clinical Sciences and Community Health, University of Milan, Milan, EU, Italy.
Dept of Woman Mother and Neonate, Buzzi Children's Hospital, University of Milan, EU, Italy.
Eur J Obstet Gynecol Reprod Biol. 2019 Feb;233:151-157. doi: 10.1016/j.ejogrb.2018.12.018. Epub 2018 Dec 20.
We investigated the role of body mass index (BMI) and maternal age on the risk of late-term induction, prolonged induction time and caesarean section (CS) after induction.
This is a retrospective, observational study. All women without any fetal or maternal pathological condition, uterine scars or any other indication for an elective caesarean birth and had a singleton foetus in the cephalic position at term were included.
A total of 4006 women had a spontaneous onset of labour and 612 were induced for a late-term pregnancy. Labour induction was significantly more common in overweight (Adj Odds Ratio (OR) 1.48 95%CI 1.22-1.78) and obese (Adj OR 1.63 95%CI 1.24-2.14) women. Among induced women, a BMI ≥ 30 was a risk factor for a prolonged induction time in both nulliparous (AdjOR 2.4, 95%CI 1.02-5.67) and multiparous women (AdjOR 4.24, 95%CI 1.02-17.6). A BMI > 25-29.9 was significantly associated with a prolonged induction time only in nulliparous women (AdjOR 1.86 95%CI 1.05-3.30). A CS was more frequent in overweight (AdjOR 1.74, 95% CI 1.052.89) and obese women (AdjOR 2.72, 95%CI 1.42-5.25). Nulliparous women ageed 30-34 years had an induction time longer than women <30 years (OR 2.04 95%CI 1.07-3.91).
The results of this study suggest that a BMI > 25 kg/m2 at term of pregnancy is a risk factor for the induction of labour during a late-term pregnancy, a prolonged induction time and higher caesarean section rate.
我们研究了体重指数（BMI）和产妇年龄对晚期引产、引产时间延长及引产后剖宫产（CS）风险的影响。
这是一项回顾性观察研究。纳入所有无任何胎儿或母体病理状况、子宫瘢痕或任何其他择期剖宫产指征且足月时单胎头位的女性。
共有4006名女性自然分娩，612名因晚期妊娠接受引产。引产在超重（调整优势比（OR）1.48，95%置信区间1.22 - 1.78）和肥胖（调整OR 1.63，95%置信区间1.24 - 2.14）女性中显著更常见。在引产女性中，BMI≥30是初产妇（调整OR 2.4，95%置信区间1.02 - 5.67）和经产妇（调整OR 4.24，95%置信区间1.02 - 17.6）引产时间延长的危险因素。BMI>25 - 29.9仅在初产妇中与引产时间延长显著相关（调整OR 1.86，95%置信区间1.05 - 3.30）。剖宫产在超重（调整OR 1.74，95%置信区间1.05 - 2.89）和肥胖女性（调整OR 2.72，95%置信区间1.42 - 5.25）中更频繁。30 - 34岁的初产妇引产时间比<30岁的女性长（OR 2.04，95%置信区间1.07 - 3.91）。
本研究结果表明，妊娠晚期BMI>25 kg/m²是晚期妊娠引产、引产时间延长及剖宫产率升高的危险因素。
