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阿卜杜勒阿齐兹国王大学医院肥胖孕妇的母婴结局:一项回顾性单中心病历审查

Maternal and Neonatal Outcomes among Obese Pregnant Women in King Abdulaziz University Hospital: A Retrospective Single-Center Medical Record Review.

作者信息

Fallatah Anas M, Babatin Hussam M, Nassibi Khalid M, Banweer Mazen K, Fayoumi Mohammad N, Oraif Ayman M

机构信息

Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.

Faculty of Medicine, Jeddah University, Jeddah, Kingdom of Saudi Arabia.

出版信息

Med Arch. 2019 Dec;73(6):425-432. doi: 10.5455/medarh.2019.73.425-432.

Abstract

INTORUCTION

Pregnancy results in different physiological changes to the pregnant body resulting in weight gain. This added weight can result in poor pregnancy outcomes in obese women.

AIM

To assess the adverse maternal and neonatal outcomes among obese pregnant women.

METHODS

This is a retrospective record review conducted on obese pregnant women who delivered in the last five years attending King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Therefore, for analysis we used the following; 1- descriptive analysis, 2- Chi-square test, Pearson correlation, independent t-test, and one-way ANOVA to test the difference in obese and adverse pregnancy outcomes. Advance statistics such as binary, and multinomial logistic regression were used to examine the relationship between obesity and all adverse pregnancy outcomes.

RESULTS

A total of 1037 obese pregnant women were enrolled in our study including 620 (59.8%) obese in class I (30-34.9), 262 (25.3%) obese in class II (35-39.9), and 155 (14.9%) obese in class III (40). About 74.73% of the population were Saudis. The average age was 31.96 (5.79) years. Out of 1037 obese pregnant women, 449 did develop undesired antepartum outcomes, while 729 and 163 had adverse neonatal, and postpartum outcomes. Antepartum variables such as preeclampsia, gestational diabetes mellitus, impaired glucose tolerance test, antiphospholipid syndrome, premature rupture of membranes, placenta previa, anemia, urinary tract infection, and oligohydramnios, and rate of Cesarean section were significantly associated with obesity (P<0.05). Postpartum variables such as vaginal laceration, perianal laceration, postpartum hemorrhage, and endometritis were also significantly associated with obesity (P<0.05). Moreover, adverse neonatal outcomes such as low APGAR scores at 1 and 5 minutes, birthweight, gestational age, admission to neonatal intensive care unit, intrauterine fetal death, and neonatal death, were significant significantly associated with obesity (P<0.05).

CONCLUSION

As our study demonstrated, maternal obesity resulted in adverse outcomes for the mother and fetus. Hence, to yield a better outcome for these women and their offspring, periconceptional counseling, conducting health education, and comprehensive plan prior to their pregnancy should be enforced.

摘要

引言

怀孕会使孕妇身体发生不同的生理变化,导致体重增加。这种额外增加的体重可能会给肥胖女性带来不良的妊娠结局。

目的

评估肥胖孕妇中不良的孕产妇和新生儿结局。

方法

这是一项对过去五年在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院分娩的肥胖孕妇进行的回顾性记录审查。因此,我们在分析中使用了以下方法:1 - 描述性分析,2 - 卡方检验、皮尔逊相关性分析、独立t检验和单因素方差分析,以检验肥胖与不良妊娠结局之间的差异。还使用了二元和多项逻辑回归等高级统计方法来研究肥胖与所有不良妊娠结局之间的关系。

结果

我们的研究共纳入了1037名肥胖孕妇,其中620名(59.8%)为I级肥胖(30 - 34.9),262名(25.3%)为II级肥胖(35 - 39.9),155名(14.9%)为III级肥胖(40)。约74.73%的人群为沙特人。平均年龄为31.96(5.79)岁。在1037名肥胖孕妇中,449名确实出现了不良的产前结局,而729名和163名分别出现了不良的新生儿和产后结局。产前变量如子痫前期、妊娠期糖尿病、葡萄糖耐量试验受损、抗磷脂综合征、胎膜早破、前置胎盘、贫血、尿路感染和羊水过少以及剖宫产率与肥胖显著相关(P<0.05)。产后变量如阴道撕裂伤、肛周撕裂伤、产后出血和子宫内膜炎也与肥胖显著相关(P<0.05)。此外,不良的新生儿结局如1分钟和5分钟时的低阿氏评分、出生体重、孕周、入住新生儿重症监护病房、宫内胎儿死亡和新生儿死亡与肥胖显著相关(P<0.05)。

结论

正如我们的研究所表明的,孕产妇肥胖会给母亲和胎儿带来不良结局。因此,为了使这些女性及其后代获得更好的结局,应在受孕前进行咨询、开展健康教育并在怀孕前制定全面计划。

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