Lin Shi, Xie Chunzhi, Teng Anyi, Chen Xiaotian, Li Yan, Zhang Yangyang, Zhang Hui, Sun Ting
Department of Gynaecology and Obstetrics, Maternal and Child Health Hospital, Songjiang, Shanghai, China.
Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China.
Front Med (Lausanne). 2024 Aug 30;11:1453620. doi: 10.3389/fmed.2024.1453620. eCollection 2024.
The effects of Pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) in primiparas remain unclear. This study examines the associations of pre-pregnancy BMI and GWG with cesarean delivery after induction (CDaI) in primiparous women.
This prospective cohort study included 3,054 primiparous women. We recorded pre-pregnancy BMI, first, second, and third trimester weight values, as well as instances of CDaI and other pregnancy outcomes. We analyzed the associations of pre-pregnancy BMI and GWG with CDaI by conducting a multivariate logistic regression analysis after adjusting for covariates, and adjusted risk ratios (aRR) and 95% confidence intervals were reported.
We recorded 969 CDaIs. In the vaginal delivery group, each increase of 1 standard deviation in the pre-pregnancy BMI was correlated with a 6% increase in the CDaI risk [aRR (95% CI), 1.06 (1.01-1.11)]. Each increase of 1 standard deviation in the rate of weight gain during the entire pregnancy was correlated with a 21% increase in the CDaI risk [aRR (95% CI), 1.21 (1.14-1.29)]. Compared to women with a normal weekly GWG in the second and third trimester, those with slow GWG had a 19% increased risk of CDaI [aRR (95% CI), 1.19 (1.01-1.37)]. The subgroup analysis results showed that increases in pre-pregnancy BMI could increase the CDaI risk regardless of the induction method.
High pre-pregnancy BMI, excessive GWG, and rapid first trimester weight gain are risk factors for CDaI in primiparous women. Excessive first trimester weight gain, may associated with increased risks of CDaI in primiparous women.
初产妇孕前体重指数（BMI）和孕期体重增加（GWG）的影响尚不清楚。本研究探讨初产妇孕前BMI和GWG与引产术后剖宫产（CDaI）之间的关联。
这项前瞻性队列研究纳入了3054名初产妇。我们记录了孕前BMI、孕早期、孕中期和孕晚期的体重值，以及CDaI和其他妊娠结局的情况。在对协变量进行调整后，通过多因素逻辑回归分析来分析孕前BMI和GWG与CDaI之间的关联，并报告调整后的风险比（aRR）和95%置信区间。
我们记录到969例CDaI。在阴道分娩组中，孕前BMI每增加1个标准差，CDaI风险增加6%[aRR（95%CI），1.06（1.01 - 1.11）]。整个孕期体重增加率每增加1个标准差，CDaI风险增加21%[aRR（95%CI），1.21（1.14 - 1.29）]。与孕中期和孕晚期每周GWG正常的女性相比，GWG缓慢的女性CDaI风险增加19%[aRR（95%CI），1.19（1.01 - 1.37）]。亚组分析结果显示，无论引产方法如何，孕前BMI的增加都会增加CDaI风险。
孕前BMI高、GWG过多以及孕早期体重快速增加是初产妇CDaI的危险因素。孕早期体重增加过多可能与初产妇CDaI风险增加有关。
