Associations of maternal pre-pregnancy obesity and excess pregnancy weight gains with adverse pregnancy outcomes and length of hospital stay.
Associations of maternal pre-pregnancy obesity and excess pregnancy weight gains with adverse pregnancy outcomes and length of hospital stay.
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孕妇孕前肥胖症和过度怀孕体重的关联与不良怀孕结局和住院时间。
DOI：
10.1186/1471-2393-11-62
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发表时间：
2011-09-06
影响因子：
3.1
通讯作者：
Lawlor DA
中科院分区：
文献类型：
--
作者：
Mamun AA;Callaway LK;O'Callaghan MJ;Williams GM;Najman JM;Alati R;Clavarino A;Lawlor DA
目前尚不清楚孕前肥胖和妊娠期体重增加是否与剖腹产、妊娠并发症、早产、出生和胎盘重量以及产后住院时间增加有关。我们使用了一个基于人群的队列，其中包括1981年至1983年在澳大利亚布里斯班分娩的6632名妇女。使用多变量回归（连续结果）和多变量多项式回归（分类结果）模型检查孕前肥胖、GWG和医学研究所（IOM）分类的孕前BMI和GWG与结果的独立关联。我们发现怀孕前肥胖的妇女和怀孕期间体重增加的妇女患妊娠并发症的风险更大（OR：2.10; 1.74，2.54;年龄校正模型），剖腹产（OR 1.29; 1.09，1.54），出生体重差异较大（206.45 gm; 178.82，234.08），胎盘重量差异较大（41.16 gm; 33.83，48.49），住院时间较长。我们还发现，怀孕前体重增加不足或体重过轻的母亲早产的风险更大（2.27; 1.71，3.00），妊娠并发症风险较低（0.58; 0.44，0.77），出生体重（-190.63;-221.05，-160.20）和胎盘重量（-37.16;-45.23，-29.09）较低。结果表明，所有协会保持一致的调整后的一系列潜在的混杂因素，除了孕前肥胖和住院时间之间的关联。孕前肥胖或GWG过多与妊娠并发症、剖腹产、出生和胎盘重量增加的风险增加有关。过量的GWG与分娩后住院时间延长相关，与孕前BMI、妊娠并发症和剖腹产无关。除了孕前肥胖外，临床实践还必须将过量GWG视为不良妊娠结局的另一个指标。
It is relatively less known whether pre-pregnancy obesity and excess gestational weight gain (GWG) are associated with caesarean delivery, pregnancy complications, preterm birth, birth and placenta weights and increased length of postnatal hospital stay. We used a population-based cohort of 6632 women who gave birth in Brisbane, Australia, between 1981 and 1983. The independent associations of pre-pregnancy obesity, GWG and institute of medicine (IOM) categories of combined pre-pregnancy BMI and GWG with outcomes were examined using multivariable regression (for continuous outcomes) and multivariable multinomial regression (for categorical outcomes) models. We found women who were obese prior to pregnancy and women who gained excess weight during pregnancy were at greater risk for a pregnancy complications (OR: 2.10; 1.74, 2.54; age adjusted model), caesarean section (OR 1.29; 1.09, 1.54), higher birth weight difference (206.45 gm; 178.82, 234.08) and greater placental weight difference (41.16 gm; 33.83, 48.49) and longer length of hospital stay. We also found that mothers who gained inadequate weight or were underweight before pregnancy were at greater risk of preterm birth (2.27; 1.71, 3.00), lower risk of pregnancy complications (0.58; 0.44, 0.77) and had lower birth (-190.63;-221.05,-160.20) and placental (-37.16; -45.23,-29.09) weights. Results indicate that all associations remain consistent after adjustment for a range of potential confounding factors with the exception of the association between pre-pregnancy obesity and hospital stay. Pre-pregnancy obesity or excessive GWG are associated with greater risk of pregnancy complications, caesarean delivery and greater birth and placenta weight. Excess GWG is associated with a longer stay in hospital after delivery, independent of pre-pregnancy BMI, pregnancy complications and caesarean delivery. In addition to pre-pregnancy obesity, it is vital that clinical practice considers excess GWG as another indicator of adverse pregnancy outcomes.