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评估肥胖孕妇的母婴围产结局。

Evaluation of maternal and perinatal outcomes in pregnancy with high BMI.

机构信息

School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.

出版信息

Ir J Med Sci. 2021 Nov;190(4):1439-1444. doi: 10.1007/s11845-020-02456-4. Epub 2021 Jan 11.

DOI:10.1007/s11845-020-02456-4
PMID:33428089
Abstract

BACKGROUND

Maternal obesity is a significant risk factor for unfavourable outcomes during pregnancy. However, the extent of this relationship is poorly defined in Irish mothers.

AIMS

This study was to compare maternal and perinatal outcomes between obese and non-obese mothers in an Irish population.

METHODS

A retrospective comparative study was conducted in a secondary level maternity unit for births recorded between January 2018 and January 2019 and 2,793 women were included. BMI calculated at booking visit was used to compare obese (BMI ≥ 30 kg/m) and non-obese mothers (BMI < 30 kg/m).

RESULTS

Of 2,793 women included in this study, 2111 had a BMI < 30 kg/m and 682 had a BMI ≥ 30 kg/m. Obese women were less likely to experience spontaneous onset of labour (33.4% vs. 48.1%, p < 0.001) and more likely to be induced (37.2% vs. 31.0%, p = 0.002). Obesity was associated with a statistically significant increase in stillbirth, fetal macrosomia and emergency caesarean birth rates, whereas operative vaginal deliveries were significantly decreased. Miscarriage, shoulder dystocia, post-partum haemorrhage and spontaneous vaginal deliveries were reduced while elective caesarean birth and low birth weight incidence were increased in obese mothers; however, these results were not statistically significant.

CONCLUSIONS

This study highlights the magnitude of obstetric risks that are associated with maternal obesity within Irish population. Implementation of effective intervention strategies to reduce the number of obese women in pregnancy may have beneficial effects on pregnancy outcomes in Ireland.

摘要

背景

母体肥胖是妊娠不良结局的一个重要危险因素。然而,在爱尔兰母亲中,这种关系的程度还没有得到很好的定义。

目的

本研究旨在比较爱尔兰人群中肥胖母亲和非肥胖母亲的母婴结局。

方法

对 2018 年 1 月至 2019 年 1 月期间记录的分娩进行了二级产科单位的回顾性比较研究,共纳入 2793 名妇女。使用预约时计算的 BMI 来比较肥胖(BMI≥30kg/m)和非肥胖母亲(BMI<30kg/m)。

结果

在这项研究中,2793 名妇女中,2111 名 BMI<30kg/m,682 名 BMI≥30kg/m。肥胖妇女自发性分娩的可能性较小(33.4% vs. 48.1%,p<0.001),而诱导分娩的可能性较大(37.2% vs. 31.0%,p=0.002)。肥胖与死胎、胎儿巨大儿和紧急剖宫产率的统计学显著增加相关,而阴道分娩的手术率显著降低。肥胖母亲的流产、肩难产、产后出血和自然阴道分娩减少,而选择性剖宫产和低出生体重发生率增加;然而,这些结果没有统计学意义。

结论

本研究强调了在爱尔兰人群中,母体肥胖与产科风险的严重程度。实施有效的干预策略,减少怀孕期间肥胖妇女的数量,可能对爱尔兰的妊娠结局产生有益的影响。

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