孕妇人体测量学因素与首次剖宫产风险
Maternal anthropometric factors and risk of primary cesarean delivery.
作者信息
Shepard M J, Saftlas A F, Leo-Summers L, Bracken M B
机构信息
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn. 06520-8034, USA.
出版信息
Am J Public Health. 1998 Oct;88(10):1534-8. doi: 10.2105/ajph.88.10.1534.
OBJECTIVES
This study examined absolute and proportional gestational weight gain and prepregnancy body mass index as predictors of primary cesarean delivery.
METHODS
Data were derived from a prospective study of pregnancy outcome risk factors in 2301 women in greater New Haven, Conn, who had singleton deliveries by primary cesarean (n = 312) or vaginal delivery (n = 1989) and for whom height, prepregnancy weight, and weight gain were available. Women were divided into 4 body mass index groups (underweight, low average, high average, and obese) and further subdivided into 8 groups according to median proportional or absolute weight gain.
RESULTS
Risk of cesarean delivery increased with increasing body mass index and gestational weight gain greater than the median for one's body mass index. Proportional weight gain was more predictive of cesarean delivery than absolute weight gain. Underweight women gaining more than 27.8% of their prepregnancy weight had a 2-fold adjusted relative risk of cesarean delivery.
CONCLUSIONS
Proportional weight gain is an important predictor of cesarean delivery for underweight women; high body mass index is also predictive of increased risk.
目的
本研究探讨了绝对和相对孕期体重增加以及孕前体重指数作为初次剖宫产预测指标的情况。
方法
数据来源于对康涅狄格州大纽黑文地区2301名妇女妊娠结局风险因素的前瞻性研究，这些妇女经初次剖宫产分娩单胎（n = 312）或经阴道分娩（n = 1989），且有身高、孕前体重和体重增加的数据。将妇女分为4个体重指数组（体重过轻、低平均水平、高平均水平和肥胖），并根据中位数相对或绝对体重增加情况进一步细分为8组。
结果
剖宫产风险随着体重指数和孕期体重增加超过其体重指数中位数而增加。相对体重增加比绝对体重增加更能预测剖宫产。体重过轻的妇女孕期体重增加超过孕前体重的27.8%，其调整后的剖宫产相对风险增加两倍。
结论
相对体重增加是体重过轻妇女剖宫产的重要预测指标；高体重指数也预示着风险增加。
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