Pregnancy outcome and weight gain recommendations for the morbidly obese woman
Pregnancy outcome and weight gain recommendations for the morbidly obese woman
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DOI：
10.1016/s0029-7844(97)00578-4
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发表时间：
1998-01-01
影响因子：
7.2
通讯作者：
Lockwood, CJ
中科院分区：
文献类型：
--
作者：
Bianco, AT;Smilen, TW;Lockwood, CJ
目的：比较病态肥胖和非肥胖妇女的妊娠结局，并确定妊娠体重增加对病态肥胖妇女妊娠结局的影响。方法：回顾性队列研究比较了613名病态肥胖和11313名非肥胖的单胎活产妇女。病态肥胖被定义为身体质量指数大于35。评估两组围产儿和新生儿结局的发生率。在控制潜在混杂因素的同时，采用多元逻辑回归分析来评估病态肥胖与各种结果指标之间的关系。对病态肥胖患者进行亚分析，以评估妊娠期体重增加对妊娠结局的影响。结果：病态肥胖患者更容易出现妊娠并发症，包括糖尿病、高血压、先兆子痫和分娩停止障碍；然而，这些并不受妊娠期体重增加的影响。与非肥胖患者相比，病态肥胖患者更容易出现胎儿窘迫、胎便和剖宫产（P < 0.05）。体重增加超过25磅与出生大胎龄（LGA）新生儿密切相关（P < 0.01）；然而，体重增加不明显并不会增加低出生体重新生儿的风险。结论：妊娠期体重增加与不良围产期结局无关，但影响新生儿结局。为了降低分娩LGA新生儿的风险，病态肥胖妇女的最佳妊娠体重增加不应超过25磅。
Objective: To compare pregnancy outcomes between morbidly obese and nonobese women and to determine the effect of gestational weight gain on pregnancy outcome in morbidly obese women.Methods: A retrospective cohort study was conducted comparing 613 morbidly obese and 11,313 nonobese women who were delivered of a singleton live birth. Morbid obesity was defined as a body mass index greater than 35. The incidence of selected perinatal and neonatal outcomes was assessed for the two groups. Multiple logistic regression analysis was used to evaluate the association between morbid obesity and various measures of outcome while controlling for potential confounders. A subanalysis of the morbidly obese patients was performed to assess the effect of gestational weight gain on pregnancy outcome.Results: Morbidly obese patients were more likely to experience pregnancy complications including diabetes, hypertension, preeclampsia, and arrest-of-labor disorders; however, these were not affected by gestational weight gain. Morbidly obese patients were more likely to experience fetal distress and meconium and to undergo cesarean delivery than their nonobese counterparts (P < .05). Weight gains of more than 25 lb were associated strongly with birth of a large for gestational age (LGA) neonate (P < .01); however, poor weight gain did not appear to increase the risk of delivery of a low birth weight neonate.Conclusion: Gestational weight gain was not associated with adverse perinatal outcome, but it did influence neonatal outcome. To reduce the risk of delivery of an LGA newborn, the optimal gestational weight gain for morbidly obese women should not exceed 25 lb.