Department of Obstetrics and Gynecology, The University of Texas Health Science Center/McGovern Medical School, Houston, TX, USA.
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):6172-6179. doi: 10.1080/14767058.2021.1909559. Epub 2021 Apr 11.
Mortality figures and national health surveillance data have demonstrated that Hispanics have a 24% lower risk of all-cause mortality compared to their non-Hispanic counterparts despite increased rates of obesity and related illnesses.
The aim of this study is to evaluate if this paradox exists for obesity-related perinatal outcomes in otherwise low-risk Hispanic women.
A prospective cohort study of low-risk women across all BMI classes with a singleton, non-anomalous term pregnancy admitted in active labor or undergoing induction of labor between May 2014 and April 2017. All demographic, obstetric, and neonatal outcomes were recorded, and the body mass index (BMI) closest to delivery was used for analysis. Data including composites of adverse maternal and neonatal outcomes were compared across BMI classes and between individuals of Hispanic and non-Hispanic ethnicity. Women with antenatal complications, prior cesarean delivery, and cesarean for non-reassuring fetal status were excluded.
Of the 11,369 women who met inclusion criteria, 6303 (55%) were Hispanic. Eight percent of Hispanic women were normal weight (BMI: 18.5-24.9), 34% were overweight (BMI: 25-29.9), and 58% were obese (BMI > 30). Fourteen percent of non-Hispanic women were normal weight, 42% were overweight, and 44% were obese. The majority (65%) of women were multiparous. Rate of induction and birthweight increased across BMI for Hispanic and non-Hispanic groups, however the route of delivery was not significantly different ( = .22, 0.16, respectively). Although the association between BMI and composite perinatal complications did not differ by BMI class and ethnicity, the newborns of non-Hispanic women were more likely to be admitted to the neonatal intensive care unit with increasing maternal weight class (<0.001), even after adjusting for age, parity, marital status, prenatal visits, current tobacco use, type of labor, mode of delivery, and birthweight.
There were no demonstrable differences in composite adverse maternal or neonatal outcomes between Hispanic and non-Hispanic obese women. However, newborns of non-Hispanic obese women were more likely to be transferred to the neonatal intensive care unit with increasing maternal BMI.
死亡率数据和国家健康监测数据表明，与非西班牙裔人群相比，西班牙裔人群的全因死亡率低 24%，尽管他们的肥胖率和相关疾病发病率更高。
本研究旨在评估对于其他低风险的西班牙裔女性，这种肥胖相关的围产期结局的悖论是否存在。
这是一项前瞻性队列研究，纳入了 2014 年 5 月至 2017 年 4 月期间所有 BMI 类别、单胎、足月妊娠、活跃分娩或引产的低风险女性。记录所有人口统计学、产科和新生儿结局，并使用最接近分娩的体重指数（BMI）进行分析。比较了 BMI 类别之间以及西班牙裔和非西班牙裔个体之间的复合不良母婴结局数据。排除有产前并发症、既往剖宫产和因胎儿情况不乐观而行剖宫产的女性。
在符合纳入标准的 11369 名女性中，有 6303 名（55%）为西班牙裔。8%的西班牙裔女性为正常体重（BMI：18.5-24.9），34%为超重（BMI：25-29.9），58%为肥胖（BMI>30）。14%的非西班牙裔女性为正常体重，42%为超重，44%为肥胖。大多数（65%）女性为多产妇。西班牙裔和非西班牙裔女性的诱导分娩率和出生体重均随 BMI 增加而增加，但分娩方式无显著差异（=0.22，0.16）。尽管 BMI 与复合围产期并发症之间的关联不因 BMI 类别和种族而异，但非西班牙裔女性的新生儿更有可能因母亲体重增加而被送入新生儿重症监护病房（<0.001），即使在校正了年龄、产次、婚姻状况、产前检查、当前吸烟状况、分娩方式、分娩方式和出生体重后。
在肥胖的西班牙裔和非西班牙裔女性中，复合不良母婴结局没有明显差异。然而，非西班牙裔肥胖女性的新生儿更有可能因母亲 BMI 的增加而被转至新生儿重症监护病房。
