Qazi Qudsia, Liaqat Nazia, Hussain Shehzadi Saima, Syed Wajeeha
Dr. Qudsia Qazi, FCPS (Obs&Gynae) Associate Professor, Department of Obstetrics & Gynaecology, Medical Teaching Institute, Lady Reading Hospital, Peshawar, Pakistan.
Dr. Nazia Liaqat, FCPS (Obs&Gynae) Assistant Professor, Department of Obstetrics & Gynaecology, Medical Teaching Institute, Lady Reading Hospital, Peshawar, Pakistan.
Pak J Med Sci. 2022 May-Jun;38(5):1371-1375. doi: 10.12669/pjms.38.5.4815.
Obesity with its growing prevalence is a major public health problem influencing gestational age at delivery. Raised Body Mass Index (BMI) has been shown to be associated with significantly increased risk of prolonged pregnancy; which is an important contributor to perinatal morbidity and mortality. Obesity needs modified antenatal, intrapartum and postpartum care by obstetrician. Limited data is found regarding association of obesity with prolonged pregnancy and the same fact led us to search for this association.
This cohort study was carried out in Gynecology and Obstetrics department, MTI Lady Reading Hospital Peshawar from March 2020 to April 2021. Patients were enrolled in third trimester at 37 weeks of gestation with primary exposures of interest being either self-reported pre-pregnancy weight or obtained from first trimester antenatal record. Patients were divided into two classes based on BMI i.e., one with BMI <25 and other with BMI ≥ 25. Patients in both classes were followed till their delivery to determine outcome of gestational age at delivery.
Statistically significant difference between the two groups was seen at lower age range of 18-21 years(p-0.04) and higher age range of 39-42 years (p-0.0001). Statistically significant association was found between high pre pregnancy BMI and postdates pregnancy (OR: 4.93 ;95% CI: 1.98-12.26, p-0.001). Association of induction of labor with high pre pregnancy BMI was not significant. (OR 0.56, 95% CI: 0.21-1.48, P < 0.001). Higher rates of Instrumental deliveries(p-0.0005) and cesarean sections (p-0.0001) were seen in higher BMI group.
Higher pre-pregnancy BMI is associated with increased risk of postdates pregnancy.
肥胖症患病率不断上升，是影响分娩孕周的一个主要公共卫生问题。已表明，体重指数（BMI）升高与妊娠延长风险显著增加相关；而妊娠延长是围产期发病和死亡的一个重要因素。肥胖症需要产科医生对产前、产时和产后护理进行调整。关于肥胖症与妊娠延长之间的关联，现有数据有限，正是这一情况促使我们探究这种关联。
这项队列研究于2020年3月至2021年4月在白沙瓦MTI女读医院妇产科开展。患者在妊娠37周的孕晚期入组，主要感兴趣的暴露因素为自我报告的孕前体重或从孕早期产前记录中获取的体重。患者根据BMI分为两类，即BMI<25的一类和BMI≥25的另一类。对两类患者进行随访直至分娩，以确定分娩时的孕周结局。
在18 - 21岁的较低年龄范围（p = 0.04）和39 - 42岁的较高年龄范围（p = 0.0001），两组之间存在统计学显著差异。孕前BMI高与过期妊娠之间存在统计学显著关联（比值比：4.93；95%置信区间：1.98 - 12.26，p = 0.001）。孕前BMI高与引产之间不存在显著关联（比值比0.56，95%置信区间：0.21 - 1.48，P < 0.001）。BMI较高组的器械助产率（p = 0.0005）和剖宫产率（p = 0.0001）更高。
孕前BMI较高与过期妊娠风险增加相关。
