Jones Sara I, Rosenthal Elise A, Pruszynski Jessica E, Cunningham F Gary
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas.
Am J Perinatol. 2025 Sep;42(12):1594-1602. doi: 10.1055/a-2515-2673. Epub 2025 Jan 14.
This study aimed to evaluate the frequency of adverse maternal and neonatal outcomes associated with maternal obesity in a Hispanic population. We hypothesized that obesity confers a dose-dependent risk associated with these outcomes.This was a retrospective cohort study of singleton pregnancies delivered between 24 and 42 weeks gestation at an urban county hospital between 2013 and 2021. Body mass index (BMI) at the first prenatal visit was used as a proxy for prepregnancy weight. Patients were excluded if their first-trimester BMI was not available. Trends in adverse outcomes across increasing obesity classes were assessed.During the study period, 58,497 patients delivered a singleton infant, of which 12,365 (21.1%), 5,429 (9.3%), and 3,482 (6.0%) were in class I, II, and III obesity, respectively. Compared with nonobese patients, obese patients were more likely to be younger and nulliparous with a higher incidence of hypertension and pregestational diabetes. Higher BMI was associated with a significant dose-dependent increase in cesarean delivery (27% for nonobese, 34% for class I, 39% for class II, and 46% for class III obesity); severe preeclampsia (8% in nonobese and 19% for class III obesity); and gestational diabetes (5% in nonobese and 15% in class III obesity). There were significant trends in increasing morbidity for infants born to patients with correspondingly higher obesity classes. Some of these adverse outcomes included respiratory distress syndrome, neonatal intensive care unit admission, fetal anomalies, and sepsis (all < 0.001).Increasing body mass index is associated with a significant dose-dependent increase in multiple adverse perinatal outcomes in a Hispanic population. Associated adverse maternal outcomes include severe preeclampsia, gestational diabetes, and cesarean delivery. Infants born to patients with correspondingly higher BMI class have significantly increased associated morbidity. Often, only higher BMI classes are significantly associated with these adverse outcomes. · As BMI increases, pregnant patients are more likely to experience adverse maternal and neonatal outcomes.. · Many adverse pregnancy outcomes are associated only with a BMI greater than 40 kg/m2.. · Obesity is associated with cesarean delivery, likely due to an increase in labor dystocia..
本研究旨在评估西班牙裔人群中与孕产妇肥胖相关的不良孕产妇和新生儿结局的发生频率。我们假设肥胖会带来与这些结局相关的剂量依赖性风险。
这是一项回顾性队列研究，研究对象为2013年至2021年期间在一家城市县级医院妊娠24至42周分娩的单胎妊娠。首次产前检查时的体重指数（BMI）用作孕前体重的替代指标。如果无法获得孕早期BMI，则将患者排除。评估了肥胖等级增加时不良结局的趋势。
在研究期间，58497名患者分娩了单胎婴儿，其中12365名（21.1%）、5429名（9.3%）和3482名（6.0%）分别属于I级、II级和III级肥胖。与非肥胖患者相比，肥胖患者更年轻且初产比例更高，高血压和孕前糖尿病的发病率更高。较高的BMI与剖宫产的显著剂量依赖性增加相关（非肥胖患者为27%，I级肥胖为34%，II级肥胖为39%，III级肥胖为46%）；重度子痫前期（非肥胖患者为8%，III级肥胖为19%）；以及妊娠期糖尿病（非肥胖患者为5%，III级肥胖为15%）。肥胖等级相应较高的患者所生婴儿的发病率有显著上升趋势。其中一些不良结局包括呼吸窘迫综合征、新生儿重症监护病房入院、胎儿畸形和败血症（均P<0.001）。
体重指数增加与西班牙裔人群中多种不良围产期结局的显著剂量依赖性增加相关。相关的不良孕产妇结局包括重度子痫前期、妊娠期糖尿病和剖宫产。BMI等级相应较高的患者所生婴儿的相关发病率显著增加。通常，只有较高的BMI等级与这些不良结局显著相关。·随着BMI增加，孕妇更有可能经历不良孕产妇和新生儿结局。·许多不良妊娠结局仅与BMI大于40kg/m²相关。·肥胖与剖宫产相关，可能是由于产程难产增加。
