Asah-Opoku Kwaku, Pijtak Iris, Nuamah Mercy, Damale Nelson, Bloemenkamp Kitty, Browne Joyce, Rijken Marcus J
Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana.
Department of Obstetrics and Gyecology, Korle-Bu Teaching Hospital, Accra, Ghana.
Int J Gynaecol Obstet. 2022 Jun;157(3):514-521. doi: 10.1002/ijgo.13923. Epub 2021 Sep 27.
Obesity and cesarean section (CS) rates are rising in sub-Saharan Africa (SSA), where risks for complications that adversely affect maternal health, such as infections, are high.
To conduct a systematic review and meta-analysis to report on the incidence and types of body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters)-related complications following CS in SSA.
A systematic search was conducted in PubMed/MEDLINE, EMBASE, and Global Health Library up to August 2020 using (MeSH) terms related to CS, BMI, and SSA.
Quantitative studies that evaluated BMI-related complications of CS in English.
Data were extracted using a standardized form. The risk of bias was assessed using the Newcastle-Ottawa Scale. The incidence of BMI-related complications at 95% confidence interval was calculated and a meta-analysis conducted.
Of 84 articles screened, five were included. Complications associated with a higher BMI were: wound infection, hemorrhage, post-dural puncture headache, and prolonged surgery time in comparison with patients with a normal BMI. Women with a high BMI (>25.0) have a two-fold increased risk for post-cesarean wound infection compared with women with a normal BMI (20.0-24.9) (odds ratio 1.91, 95% confidence interval 1.11-3.52).
Overweight and obesity were associated with CS complications in SSA, but limited research is available.
在撒哈拉以南非洲地区（SSA），肥胖率和剖宫产（CS）率正在上升，该地区诸如感染等对孕产妇健康产生不利影响的并发症风险很高。
进行一项系统评价和荟萃分析，以报告SSA地区剖宫产术后与体重指数（BMI，计算方法为千克体重除以米身高的平方）相关并发症的发生率和类型。
截至2020年8月，在PubMed/MEDLINE、EMBASE和全球健康图书馆中进行了系统检索，使用了与剖宫产、BMI和SSA相关的医学主题词（MeSH）。
用英文评估剖宫产BMI相关并发症的定量研究。
使用标准化表格提取数据。采用纽卡斯尔-渥太华量表评估偏倚风险。计算95%置信区间内BMI相关并发症的发生率并进行荟萃分析。
在筛选的84篇文章中，纳入了5篇。与正常BMI患者相比，较高BMI相关的并发症有：伤口感染、出血、硬膜外穿刺后头痛和手术时间延长。BMI高（>25.0）的女性剖宫产术后伤口感染风险是BMI正常（20.0-24.9）女性的两倍（比值比1.91，95%置信区间1.11-3.52）。
在SSA地区，超重和肥胖与剖宫产并发症相关，但现有研究有限。
