Balki Indranil, Sheth Heet, Shafey Amy, Maxwell Cynthia, Stephens Derek, Shah Vibhuti
Department of Paediatrics, Mount Sinai Hospital, Toronto, ON.
Department of Obstetrics and Gynaecology, Division of Maternal Fetal Medicine, Mount Sinai Hospital, Toronto, ON.
J Obstet Gynaecol Can. 2019 Aug;41(8):1150-1156. doi: 10.1016/j.jogc.2018.11.011. Epub 2019 Jan 25.
With maternal obesity rates and twin pregnancies on the rise, the aim of this study was to assess the impact of pre-pregnancy or first trimester BMI on short-term neonatal morbidities in twins admitted to a level I unit.
This retrospective single-centre cohort study was conducted on twins born between January 1, 2010 and December 31, 2013 and admitted to the level I unit at Mount Sinai Hospital in Toronto, Ontario. Twin pairs were categorized according to maternal BMI: underweight (<18.5 kg/m), normal weight (18.5-24.9 kg/m), overweight (25.0-29.9 kg/m), and obese (≥30 kg/m). The primary outcome was combined neonatal morbidities of hypoglycemia and hyperbilirubinemia. The secondary outcome was length of hospital stay. All outcomes were compared between twins in various BMI groups, and data were analyzed using the chi-square test or ANOVA (Canadian Task Force Classification II-2).
Data on 700 neonates born to 350 women were analyzed. Baseline maternal and neonatal characteristics were similar between the groups, except for a statistically significantly higher incidence of maternal hypertension (P < 0.02) and a trend towards increased gestational diabetes rates (P = 0.05) in women with overweight or obesity compared with women with underweight or normal weight. No association was noted between maternal BMI and occurrence of neonatal hypoglycemia, hyperbilirubinemia, and length of stay in either twin pair (P > 0.05) CONCLUSION: Maternal BMI had no detectable effect on neonatal morbidities and length of stay in twins admitted to the level I unit in the study centre.
随着孕产妇肥胖率和双胎妊娠率的上升，本研究旨在评估孕前或孕早期体重指数（BMI）对入住一级医疗单位的双胎新生儿短期发病率的影响。
本回顾性单中心队列研究对2010年1月1日至2013年12月31日出生并入住安大略省多伦多市西奈山医院一级医疗单位的双胎进行。双胎根据母亲的BMI分类：体重过轻（<18.5kg/m）、正常体重（18.5-24.9kg/m）、超重（25.0-29.9kg/m）和肥胖（≥30kg/m）。主要结局是低血糖和高胆红素血症合并的新生儿发病率。次要结局是住院时间。比较各BMI组双胎的所有结局，并使用卡方检验或方差分析进行数据分析（加拿大工作组分类II-2）。
分析了350名女性所生700名新生儿的数据。各组间孕产妇和新生儿的基线特征相似，但超重或肥胖女性的孕产妇高血压发病率在统计学上显著更高（P<0.02），且妊娠期糖尿病发生率有上升趋势（P=0.05），而体重过轻或正常体重的女性则无此情况。在任何一对双胎中，均未发现母亲BMI与新生儿低血糖、高胆红素血症的发生及住院时间之间存在关联（P>0.05）。结论：在研究中心入住一级医疗单位的双胎中，母亲BMI对新生儿发病率和住院时间没有可检测到的影响。
