Kureshi Azima, Khalak Rubia, Gifford Jamie, Munshi Upender
Department of Pediatrics, Albany Medical College, Albany, NY, United States.
Front Pediatr. 2022 May 25;10:867171. doi: 10.3389/fped.2022.867171. eCollection 2022.
Maternal obesity has been associated with pregnancy-related complications and neonatal morbidities. The primary aim of this study was to evaluate early neonatal morbidities associated with maternal obesity from the infant-mother dyad data set at a single, large Regional Perinatal Center (RPC) in NY. A retrospective chart review of all mother-infant dyads born from January 2009 to December 2019 was done. Maternal obesity was defined using the NIH definition of pre-pregnancy body mass index (BMI) ≥ 30 Kg/m. Maternal data included pre-pregnancy BMI, gestational diabetes, hypertension, and mode of delivery. Neonatal data recorded the birth weight, gestational age, respiratory support after delivery, diagnosis of transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), neonatal hypoglycemia (NH), and hypoxic-ischemic encephalopathy (HIE). Diagnosis of TTN, RDS, NH, and HIE was defined by the service neonatologist and cross-checked by the data system review neonatologist. Medical records of 22,198 infant-mother dyads included in the study had 7,200 infants (32.4%) born to obese mothers and 14,998 infants (67.6%) born to non-obese women. There was a statistically significant increase in the diagnosis of gestational diabetes, gestational hypertension, and cesarean deliveries in obese mothers. Diagnosis of TTN, RDS, and NH was significantly higher in infants born to obese mothers, while HIE incidence was similar in both the groups. Infants born to obese mothers are more likely to be delivered by cesarean section and are at a higher risk of diagnosis of transient tachypnea of newborn, respiratory distress syndrome, and hypoglycemia in the early neonatal period.
孕妇肥胖与妊娠相关并发症及新生儿疾病有关。本研究的主要目的是从纽约一家大型区域围产期中心（RPC）的母婴二元数据集评估与孕妇肥胖相关的早期新生儿疾病。对2009年1月至2019年12月出生的所有母婴二元组进行了回顾性病历审查。孕妇肥胖采用美国国立卫生研究院（NIH）孕前体重指数（BMI）≥30 Kg/m的定义。孕妇数据包括孕前BMI、妊娠期糖尿病、高血压和分娩方式。新生儿数据记录了出生体重、胎龄、出生后呼吸支持、新生儿短暂性呼吸急促（TTN）、呼吸窘迫综合征（RDS）、新生儿低血糖（NH）和缺氧缺血性脑病（HIE）的诊断情况。TTN、RDS、NH和HIE的诊断由新生儿科医生确定，并经数据系统审查新生儿科医生交叉核对。该研究纳入的22198对母婴二元组的病历中，有7200名婴儿（32.4%）为肥胖母亲所生，14998名婴儿（67.6%）为非肥胖女性所生。肥胖母亲的妊娠期糖尿病、妊娠期高血压和剖宫产的诊断率有统计学意义的显著增加。肥胖母亲所生婴儿的TTN、RDS和NH诊断率显著更高，而两组的HIE发病率相似。肥胖母亲所生婴儿更有可能通过剖宫产分娩，且在新生儿早期被诊断为新生儿短暂性呼吸急促、呼吸窘迫综合征和低血糖的风险更高。
