Ballesta-Castillejos Ana, Gómez-Salgado Juan, Rodríguez-Almagro Julián, Ortiz-Esquinas Inmaculada, Hernández-Martínez Antonio
Department of Obstetrics and Gynecology, Talavera de la Reina, 45600 Toledo, Spain.
Department of Sociology, Social Work and Public Health, University of Huelva, 21071 Huelva, Spain.
J Clin Med. 2020 Mar 5;9(3):707. doi: 10.3390/jcm9030707.
Over the past few decades, overweight and obesity have become a growing health problem of particular concern for women of reproductive age as obesity in pregnancy has been associated with increased risk of obstetric and neonatal complications. The objective of this study is to describe the incidence of obstetric and perinatal complications in relation to maternal body mass index (BMI) at the time prior to delivery within the Spanish Health System. For this purpose, a cross-sectional observational study was conducted aimed at women who have been mothers between 2013 and 2018 in Spain. Data were collected through an online survey of 42 items that was distributed through lactation associations and postpartum support groups. A total of 5871 women answered the survey, with a mean age of 33.9 years (SD = 4.26 years). In the data analysis, crude odds ratios (OR) and adjusted odds ratios (AOR) were calculated through a multivariate analysis. A linear relationship was observed between the highest BMI figures and the highest risk of cephalopelvic disproportion (AOR of 1.79 for obesity type III (95% CI: 1.06-3.02)), preeclampsia (AOR of 6.86 for obesity type III (3.01-15.40)), labor induction (AOR of 1.78 for obesity type III (95% CI: 1.16-2.74)), emergency C-section (AOR of 2.92 for obesity type III (95% CI: 1.68-5.08)), morbidity composite in childbirth (AOR of 3.64 for obesity type III (95% CI: 2.13-6.24)), and macrosomia (AOR of 6.06 for obesity type III (95% CI: 3.17-11.60)), as compared with women with normoweight. Women with a higher BMI are more likely to develop complications during childbirth and macrosomia.
在过去几十年中，超重和肥胖已成为育龄女性日益严重的健康问题，因为孕期肥胖与产科和新生儿并发症风险增加有关。本研究的目的是描述西班牙医疗系统中分娩前产妇体重指数（BMI）与产科及围产期并发症的发生率。为此，开展了一项横断面观察性研究，对象为2013年至2018年期间在西班牙生育过的女性。数据通过一项包含42个项目的在线调查收集，该调查通过哺乳协会和产后支持小组进行分发。共有5871名女性回答了调查，平均年龄为33.9岁（标准差=4.26岁）。在数据分析中，通过多变量分析计算了粗比值比（OR）和调整比值比（AOR）。观察到最高BMI数值与头盆不称的最高风险（III型肥胖的AOR为1.79（95%置信区间：1.06 - 3.02））、先兆子痫（III型肥胖的AOR为6.86（3.01 - 15.40））、引产（III型肥胖的AOR为1.78（95%置信区间：1.16 - 2.74））、急诊剖宫产（III型肥胖的AOR为2.92（95%置信区间：1.68 - 5.08））、分娩并发症综合指数（III型肥胖的AOR为3.64（95%置信区间：2.13 - 6.24））以及巨大儿（III型肥胖的AOR为6.06（95%置信区间：3.17 - 11.60））之间存在线性关系，与体重正常的女性相比。BMI较高的女性在分娩期间更易出现并发症和巨大儿。
