Crane S S, Wojtowycz M A, Dye T D, Aubry R H, Artal R
Department of Obstetrics and Gynecology, State University of New York Health Science Center at Syracuse, USA.
Obstet Gynecol. 1997 Feb;89(2):213-6. doi: 10.1016/S0029-7844(96)00449-8.
To explore the relationship between pre-pregnancy obesity and the risk for cesarean delivery.
The population studied included 20,130 women with live births after 20 weeks' gestation in central New York state between June 1, 1994, and May 31, 1995. Women who were obese before pregnancy were compared with nonobese women with regard to mode of delivery. Obesity was defined as body mass index (BMI) greater than 29. Separate analyses were conducted on the entire sample and on a subset of women with singleton pregnancies and no prior cesarean deliveries, as an estimate of the risk of primary cesarean delivery in obese women. Statistical analyses included chi 2 test, crude odds ratio (OR) with 95% confidence interval (CI), and adjusted OR with 95% CI, using logistic regression to control for confounding variables.
The adjusted OR was 1.64 (95% CI 1.46, 1.83) for obese women with singleton pregnancies and no prior cesarean deliveries to undergo cesarean delivery. The adjusted OR was 1.66 (95% CI 1.51, 1.82) for obese women in the entire sample to undergo cesarean delivery. In addition, increasing BMI was associated with increased risk for cesarean delivery.
Compared with nonobese women, women who are obese before pregnancy are at increased risk for cesarean delivery. Preconceptional counseling regarding dietary and life-style modifications may alter this pattern.
探讨孕前肥胖与剖宫产风险之间的关系。
研究人群包括1994年6月1日至1995年5月31日期间在纽约州中部妊娠20周后分娩活婴的20130名妇女。将孕前肥胖的妇女与非肥胖妇女在分娩方式方面进行比较。肥胖定义为体重指数（BMI）大于29。对整个样本以及单胎妊娠且既往无剖宫产史的妇女亚组进行单独分析，以评估肥胖妇女初次剖宫产的风险。统计分析包括卡方检验、95%置信区间（CI）的粗比值比（OR）以及95%CI的调整后OR，采用逻辑回归控制混杂变量。
单胎妊娠且既往无剖宫产史的肥胖妇女进行剖宫产的调整后OR为1.64（95%CI 1.46，1.83）。整个样本中肥胖妇女进行剖宫产的调整后OR为1.66（95%CI 1.51，1.82）。此外，BMI升高与剖宫产风险增加相关。
与非肥胖妇女相比，孕前肥胖的妇女剖宫产风险增加。关于饮食和生活方式改变的孕前咨询可能会改变这种模式。
