Bao Jing, Guan Ping
Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Wuhan, China.
Medicine (Baltimore). 2025 Jan 17;104(3):e41095. doi: 10.1097/MD.0000000000041095.
Although many studies based on different ethnic groups have analyzed the impact of maternal and infant weight on overall cesarean section rates in recent years, research on the impact of maternal and infant weight on emergency cesarean section (EmCS) rates is lacking, especially in the Chinese population. This study aimed to analyze whether maternal and fetal weight could influence the risk of EmCS. A total of 8427 nulliparous women who delivered vaginally (full-term, singleton, and cephalic presentation) were included in this study and divided into the normal vaginal delivery (VD) and EmCS groups. Of 8427 cases, 909 (10.8%) were delivered by EmCS because of failed VD. Compared with pregnant women with a normal body mass index, the risk of EmCS in overweight women increased significantly (P < .001). Birth weight > 3550 g was associated with an increased risk of EmCS. Subgroup analyses showed that among women with underweight and normal weight, old age, inadequate gestational weight gain, and large for gestational age were independent high-risk factors for EmCS (P < .05), whereas small for gestational age was the low-risk factor. Compared with the fetal distress group, the weight of newborns in the nonfetal distress group was significantly higher (P < .001), and the main cause of EmCS in women with macrosomia, large for gestational age, or birth weight ≥ 3550 g was fetal distress (P < .05). The prepregnancy maternal and fetal weights can affect the risk of EmCS. Weight management should be enhanced to control gestational weight gain according to the prepregnancy body mass index to reduce the risk of EmCS due to failed VD.
近年来，尽管许多针对不同种族群体的研究分析了母婴体重对总体剖宫产率的影响，但关于母婴体重对急诊剖宫产（EmCS）率影响的研究却很缺乏，尤其是在中国人群中。本研究旨在分析母体和胎儿体重是否会影响急诊剖宫产的风险。本研究共纳入8427例经阴道分娩的初产妇（足月、单胎、头先露），并将其分为正常阴道分娩（VD）组和急诊剖宫产组。在8427例病例中，有909例（10.8%）因阴道分娩失败而行急诊剖宫产。与体重指数正常的孕妇相比，超重孕妇发生急诊剖宫产的风险显著增加（P<0.001）。出生体重>3550g与急诊剖宫产风险增加相关。亚组分析显示，在体重过轻和体重正常的女性中，高龄、孕期体重增加不足和大于胎龄是急诊剖宫产的独立高危因素（P<0.05），而小于胎龄是低危因素。与胎儿窘迫组相比，非胎儿窘迫组新生儿体重显著更高（P<0.001），巨大儿、大于胎龄或出生体重≥3550g的女性发生急诊剖宫产的主要原因是胎儿窘迫（P<0.05）。孕前母体和胎儿体重会影响急诊剖宫产的风险。应加强体重管理，根据孕前体重指数控制孕期体重增加，以降低因阴道分娩失败导致急诊剖宫产的风险。
