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孕产妇肥胖与妊娠结局:基于新的亚洲印度人指南视角

Maternal Obesity and Pregnancy Outcome: in Perspective of New Asian Indian Guidelines.

作者信息

Kutchi Imran, Chellammal Periasamy, Akila Arthanari

机构信息

1Ex DNB Resident, Sri Gokulam Hospital, Salem, Tamilnadu India.

Consultant OBGYN, Khushbu Hospital, Botad, Gujarat India.

出版信息

J Obstet Gynaecol India. 2020 Apr;70(2):138-144. doi: 10.1007/s13224-019-01301-8. Epub 2020 Jan 13.

Abstract

BACKGROUND

Prevalence of obesity among women of reproductive age is increasing worldwide. As the prevalence increases among the women of reproductive age group, so it does among pregnant females. This study was conducted with the aim to assess obesity-related adverse maternal, neonatal and perinatal outcomes using new Asian Indian guidelines.

METHODOLOGY

Pregnant women up to 16-week gestation on first visit were enrolled. There were two exposure groups: one with BMI < 25 kg/m and second with BMI ≥ 25 kg/m matched for maternal age and parity, 100 in each group. The study focused on development of various adverse maternal and foetal/perinatal complications. Comparative analysis of data was done to estimate the odds of each outcome taking non-obese group as reference.

RESULTS

There was a significant increase in risk among obese mothers compared to non-obese mothers for maternal complications like hypertensive disorders of pregnancy{OR 3.83}, preeclampsia{OR 9.2}, gestational diabetes mellitus{OR 4.85} and insulin requirement{OR 12.46}, induction of labour{OR 2.71}, caesarean section post induction{OR 8.50}, prolonged labour{OR 4.69}, caesarean sections{OR 5.18} and postpartum haemorrhage{OR 2.21}. Also, there was a significant increase in risk among obese mothers compared to non-obese mothers for foetal and perinatal complications like miscarriages{OR 4.85}, preterm newborns{OR 4.63}, medically indicated preterm{OR 6.59}, shoulder dystocia{OR could not be calculated}, large for gestational age{OR 5.91}, hyperbilirubinaemia {OR 4.26} and neonatal intensive care unit admissions{OR 3.26}.

CONCLUSION

It was concluded that obesity defined by Asian Indian guidelines (BMI ≥ 25 kg/m) is associated with adverse pregnancy outcomes at odds comparable to western studies with obesity taken as BMI ≥ 30 kg/m.

摘要

背景

全球范围内,育龄女性肥胖率呈上升趋势。随着育龄女性群体肥胖率的上升,孕妇中的肥胖率也在上升。本研究旨在依据新的亚洲印度人指南评估与肥胖相关的不良孕产妇、新生儿及围产期结局。

方法

纳入首次就诊时妊娠16周及以内的孕妇。有两个暴露组:一组BMI<25kg/m²,另一组BMI≥25kg/m²,两组按产妇年龄和胎次匹配,每组100例。本研究聚焦于各种不良孕产妇及胎儿/围产期并发症的发生情况。以非肥胖组为参照,对数据进行对比分析以估算每种结局的比值比。

结果

与非肥胖母亲相比,肥胖母亲发生以下孕产妇并发症的风险显著增加:妊娠高血压疾病{比值比3.83}、子痫前期{比值比9.2}、妊娠期糖尿病{比值比4.85}及胰岛素需求{比值比12.46}、引产{比值比2.71}、引产术后剖宫产{比值比8.50}、产程延长{比值比4.69}、剖宫产{比值比5.18}及产后出血{比值比2.21}。此外,与非肥胖母亲相比,肥胖母亲发生以下胎儿及围产期并发症的风险也显著增加:流产{比值比4.85}、早产新生儿{比值比4.63}、医源性早产{比值比6.59}、肩难产{比值比无法计算}、大于胎龄儿{比值比5.91}、高胆红素血症{比值比4.26}及新生儿重症监护病房收治{比值比3.26}。

结论

得出结论,按照亚洲印度人指南定义的肥胖(BMI≥25kg/m²)与不良妊娠结局相关,其比值比与西方将肥胖定义为BMI≥30kg/m²的研究结果相当。

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