Comparison of three classification systems of Prepregnancy Body Mass Index with Perinatal Outcomes in Japanese Obese Pregnant Women: A retrospective study at a single center
Comparison of three classification systems of Prepregnancy Body Mass Index with Perinatal Outcomes in Japanese Obese Pregnant Women: A retrospective study at a single center
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DOI：
10.7150/ijms.47076
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发表时间：
2020-01-01
影响因子：
3.6
通讯作者：
Itoh, Hiroaki
中科院分区：
文献类型：
--
作者：
Sugimura, Ryo;Kohmura-Kobayashi, Yukiko;Itoh, Hiroaki
在日本，孕妇的孕前体重指数（BMI）为18.5 kg/m(2)、正常体重（BMI 18.5-24.9 kg/m(2)）、超重（BMI 25.0-29.9 kg/m(2)）、肥胖（BMI >= 30 kg/m2），均被诊断为肥胖。除了这四类，美国妇产科学会（ACOG）将孕前BMI分为肥胖I类（BMI 30.0-34.9 kg/m(2)）、肥胖II类（BMI 35.0-39.9 kg/m(2)）、肥胖III类（BMI >= 40 kg/m(2)）。我们进行了一项回顾性队列研究，比较了2010年至2019年期间分娩的6066名孕妇的三种不同类别的产科结局。根据日本分类，668例（11%）孕妇被归为肥胖，妊娠期高血压疾病（HDP; 3.32）、妊娠期糖尿病（GDM; 3.39）、胎龄大（LGA; 2.91）、巨大儿（4.01）的比值比（OR）显著。根据IOM的分类，474名（7.8%）和194名（3.1%）孕妇被划分为超重和肥胖。具体来说，肥胖孕妇的HDP（5.85）和GDM（5.0）的OR较高。ACOG将474名（7.8%）孕妇分类为超重，141名（2.3%）为肥胖I类，41名（0.6%）为肥胖II类，12名（0.2%）为肥胖III类。在肥胖III类患者中，HDP（12.89）、GDM（8.37）和LGA（5.74）的OR值显著较高。日本的分类可能对低风险妊娠有用，而IOM的分类可能适用于识别高风险妊娠。ACOG标准可用于逐步评估日本孕妇HDP和GDM风险；然而，二类和三类肥胖孕妇的数量很少。
In Japan, pregnant women are diagnosed as obese if the prepregnancy body mass index (BMI) is 18.5 kg/m(2)), normal weight (BMI 18.5-24.9 kg/m(2)), overweight (BMI 25.0-29.9 kg/m(2)), and obese (BMI >= 30 kg/m2). In addition to these four categories, the American College of Obstetricians and Gynecologists (ACOG) classifies prepregnancy BMI as obesity class I (BMI 30.0-34.9 kg/m(2)), obesity class II (BMI 35.0-39.9 kg/m(2)), and obesity class III (BMI >= 40 kg/m(2)). We conducted a retrospective cohort study to compare obstetric outcomes by the three different categorizations in 6,066 pregnant women who gave birth between 2010 and 2019. According to Japanese classification, 668 (11%) pregnant women were classified as obese, and significant odds ratios (OR) were observed for hypertensive disorders of pregnancy (HDP; 3.32), gestational diabetes mellitus (GDM; 3.39), large for gestational age (LGA; 2.91), and macrosomia (4.01). According to the classification of IOM, 474 (7.8%) and 194 (3.1%) were classified as overweight and obese pregnant women, respectively. Specifically, a high OR was observed in obese pregnant women for HDP (5.85) and GDM (5.0). ACOG classification categorized 474 (7.8%) pregnant women as overweight, 141 (2.3%) as obesity class I, 41 (0.6%) as obesity class II, and 12 (0.2%) as obesity class III. In obesity class III, a significantly high OR was observed for HDP (12.89), GDM (8.37), and LGA (5.74). The Japanese classification may be useful for low-risk pregnancies, whereas IOM classification may be applicable to identify high-risk pregnancies. ACOG criteria may be useful for step-wise assessments of HDP and GDM risks in Japanese pregnant women; however, the number of class II and III obese pregnant women was small.