Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Doorway 6, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
European Centre for Environmental and Human Health, College of Medicine and Health, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK.
BMJ Open. 2020 Feb 20;10(2):e026168. doi: 10.1136/bmjopen-2018-026168.
To examine the association between high maternal weight status and complications during pregnancy and delivery.
Scotland.
Data from 132 899 first-time singleton deliveries in Scotland between 2008 and 2015 were used. Women with overweight and obesity were compared with women with normal weight. Associations between maternal body mass index and complications during pregnancy and delivery were evaluated.
Gestational diabetes, gestational hypertension, pre-eclampsia, placenta praevia, placental abruption, induction of labour, elective and emergency caesarean sections, pre-term delivery, post-term delivery, low Apgar score, small for gestational age and large for gestational age.
In the multivariable models controlling for potential confounders, we found that, compared with women with normal weight, the odds of the following outcomes were significantly increased for women with overweight and obesity (overweight adjusted ORs; 95% CI, followed by the same for women with obesity): gestational hypertension (1.61; 1.49 to 1.74), (2.48; 2.30 to 2.68); gestational diabetes (2.14; 1.86 to 2.46), (8.25; 7.33 to 9.30); pre-eclampsia (1.46; 1.32 to 1.63) (2.07; 1.87 to 2.29); labour induction (1.28; 1.23 to 1.33), (1.69; 1.62 to 1.76) and emergency caesarean section (1.82; 1.74 to 1.91), (3.14; 3.00 to 3.29).
Women with overweight and obesity in Scotland are at greater odds of adverse pregnancy and delivery outcomes. The odds of these conditions increases with increasing body mass index. Health professionals should be empowered and trained to deliver promising dietary and lifestyle interventions to women at risk of overweight and obesity prior to conception, and control excessive weight gain in pregnancy.
探讨孕妇体重指数与孕期及分娩期并发症的关系。
苏格兰。
本研究使用了 2008 年至 2015 年期间苏格兰 132899 例初次单胎分娩的数据。将超重和肥胖的孕妇与体重正常的孕妇进行比较。评估了孕妇体重指数与孕期和分娩期并发症的关系。
妊娠期糖尿病、妊娠期高血压、子痫前期、前置胎盘、胎盘早剥、引产、选择性和紧急剖宫产、早产、过期产、低 Apgar 评分、小于胎龄儿和大于胎龄儿。
在控制了潜在混杂因素的多变量模型中，与体重正常的孕妇相比，超重和肥胖孕妇发生以下结局的几率显著增加（超重调整后的 OR；95%CI）：妊娠期高血压（1.61；1.49 至 1.74）、（2.48；2.30 至 2.68）；妊娠期糖尿病（2.14；1.86 至 2.46）、（8.25；7.33 至 9.30）；子痫前期（1.46；1.32 至 1.63）（2.07；1.87 至 2.29）；引产（1.28；1.23 至 1.33）、（1.69；1.62 至 1.76）和紧急剖宫产（1.82；1.74 至 1.91）、（3.14；3.00 至 3.29）。
苏格兰超重和肥胖的孕妇发生不良妊娠和分娩结局的几率更高。这些疾病的几率随着体重指数的增加而增加。应授权并培训卫生专业人员，在孕妇超重和肥胖之前，为其提供有希望的饮食和生活方式干预措施，并控制孕期体重过度增加。
