Dept of Clinical Science and Education, Unit of Obstetrics and Gynecology, Karolinska Institute, Södersjukhuset, Stockholm, Sweden.
Dept of Clinical Sciences, Intervention & Technology, Karolinska Institute, Stockholm, Sweden.
PLoS One. 2021 Apr 30;16(4):e0250983. doi: 10.1371/journal.pone.0250983. eCollection 2021.
The aim was to explore the potential role of the placenta for the risk of stillbirth at term in pregnancies of obese women.
This was a case-control study comparing placental findings from term stillbirths with placental findings from live born infants. Cases were singleton term stillbirths to normal weight or obese women, identified in the Stockholm stillbirth database, n = 264 and n = 87, respectively. Controls were term singletons born alive to normal weight or obese women, delivered between 2002-2005 and between 2018-2019. Placentas were compared between women with stillborn and live-born infants, using logistic regression analyses.
A long and hyper coiled cord, cord thrombosis and velamentous cord insertion were stronger risk factors for stillbirth in obese women compared to normal weight women. When these variables were adjusted for in the logistic regression analysis, also adjusted for potential confounders, the odds ratio for stillbirth in obese women decreased from 1.89 (CI 1.24-2.89) to 1.63 (CI 1.04-2.56).
Approximately one fourth of the effect of obesity on the risk of stillbirth in term pregnancies is explained by umbilical cord associated pathology.
旨在探讨肥胖孕妇足月妊娠死胎风险中胎盘的潜在作用。
这是一项病例对照研究，比较了来自正常体重或肥胖孕妇足月死胎的胎盘发现与来自活产婴儿的胎盘发现。病例组为在斯德哥尔摩死胎数据库中确定的 264 例和 87 例正常体重或肥胖孕妇的单胎足月死胎；对照组为 2002-2005 年和 2018-2019 年期间正常体重或肥胖孕妇分娩的单胎足月活产儿。使用逻辑回归分析比较死产和活产婴儿的胎盘。
与正常体重妇女相比，长而卷曲的脐带、脐带血栓和帆状脐带插入是肥胖妇女死产的更强风险因素。当这些变量在逻辑回归分析中进行调整，并针对潜在混杂因素进行调整时，肥胖妇女死产的比值比从 1.89（CI 1.24-2.89）降至 1.63（CI 1.04-2.56）。
肥胖对足月妊娠死胎风险的影响约有四分之一可由脐带相关病理解释。
