Cochrane Lynsey, Brumpton Kay, Winter Sacha, Bell Katrina, Burnham Harriet, Wadwell Kristen, Kitchener Scott
Griffith University, Gold Coast, Queensland, Australia.
Queensland Rural Medical Education, Toowoomba, Queensland, Australia.
Aust J Rural Health. 2019 Apr;27(2):164-169. doi: 10.1111/ajr.12495. Epub 2019 Apr 5.
To assess the prevalence of overweight and obese women in the antenatal and perinatal periods, in rural hospitals; and to evaluate neonatal and maternal outcomes, including transfer to larger birthing centres.
A retrospective clinical chart audit.
Rural maternity services in five Queensland rural hospitals.
Data were collected from 250 women presenting to participating rural hospitals, with an estimated due date in 2016.
Obstetric and neonatal data, whether transfer occurred, mode of delivery and any complications, and neonatal outcomes including birth weight and complications were collected. Demographic information collected included maternal age, gravidity and parity, race, smoking status and pre-pregnancy body mass index. The main outcome measures of interest were birth weight, Caesarean rate, transfer rate and diagnosis of gestational diabetes in relation to the body mass index.
Over 50% of women were overweight or obese while entering pregnancy, with 5.2% of mothers in the morbidly obese category. There was an increase in the birth weight of mothers with a body mass index of more than 25. The increasing body mass index was associated with an increased likelihood of transfer, diagnosis of gestational diabetes, elective and, especially, emergency Caesareans performed at the hospital. Twenty-four percent of women continued to smoke throughout pregnancy.
A high prevalence of obesity was found in the rural obstetric population. As the body mass index increases, so too does birth weight, gestational diabetes, transfer rate and Caesarean section rate. The rates of smoking throughout pregnancy were higher than the average metropolitan rates. These findings have implications not just for rural hospital operation and resources, but also for preventive health activities in rural communities.
评估农村医院产前和围产期超重及肥胖女性的患病率；并评估新生儿和产妇结局，包括转至更大分娩中心的情况。
一项回顾性临床病历审核。
昆士兰州五家农村医院的农村产科服务机构。
收集了2016年预计预产期时前往参与研究的农村医院就诊的250名女性的数据。
收集产科和新生儿数据、是否发生转院、分娩方式及任何并发症，以及包括出生体重和并发症在内的新生儿结局。收集的人口统计学信息包括产妇年龄、孕次和产次、种族、吸烟状况及孕前体重指数。主要关注的结局指标是与体重指数相关的出生体重、剖宫产率、转院率和妊娠期糖尿病的诊断情况。
超过50%的女性在怀孕时超重或肥胖，其中5.2%的母亲属于病态肥胖。体重指数超过25的母亲所生婴儿的出生体重有所增加。体重指数的增加与转院可能性增加、妊娠期糖尿病诊断、在医院进行择期尤其是急诊剖宫产的可能性增加相关。24%的女性在整个孕期持续吸烟。
农村产科人群中肥胖患病率较高。随着体重指数的增加，出生体重、妊娠期糖尿病、转院率和剖宫产率也会增加。整个孕期的吸烟率高于大城市平均水平。这些发现不仅对农村医院的运营及资源有影响，对农村社区的预防保健活动也有影响。
