The risk of adverse pregnancy outcomes in women who are overweight or obese.
The risk of adverse pregnancy outcomes in women who are overweight or obese.
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DOI：
10.1186/1471-2393-10-56
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发表时间：
2010-09-17
影响因子：
3.1
通讯作者：
Crowther CA
中科院分区：
文献类型：
--
作者：
Athukorala C;Rumbold AR;Willson KJ;Crowther CA
澳大利亚育龄妇女的肥胖率正在上升，这对产科护理具有重要影响。这项研究的目的是评估母亲在怀孕早期和中期超重和肥胖的患病率及其对母亲、围产期和新生儿结局的影响。对澳大利亚抗氧化剂维生素C和维生素E对孕妇补充抗氧化剂预防先兆子痫(ACTS)的澳大利亚合作试验中登记的单胎妊娠未分娩妇女的数据进行了二次分析。根据体重指数(BMI)将女性分为三组：正常(BMI 18.5-24.9 kg/m2)、超重(BMI 25-29.9 kg/m2)和肥胖(BMI 30-34.9 kg/m2)。通过单变量和多变量分析比较产科和围产儿结局。在纳入的1661名女性中，43%超重或肥胖。与体重指数正常的女性相比，肥胖女性患先兆子痫(相对风险为2.99[95%可信区间为1.88，4.73]，p<；0.0001)和妊娠期糖尿病(相对风险为2.10[95%可信区间为1.17，3.79]，p=0.01)的风险更高。与体重指数正常的妇女相比，肥胖和超重妇女更容易诱发并需要剖宫产(诱导-RR1.33[95%CI 1.13，1.57]，p=0.001和1.78[95%CI 1.51，2.09]，p<；0.0001，剖宫产-RR 1.42[95%CI 1.18，1.70]，p=0.0002和1.63[95%CI 1.34，1.99]，p<；0.0001)。与体重指数正常的妇女相比，肥胖妇女的婴儿在胎龄(RR2.08[95%CI1.47，2.93]，p<；0.0001)和巨大体(RR4.54[95%CI2.01，10.24]，p=0.0003)方面更有可能偏大。澳大利亚产科人口中的超重和肥胖率正在上升。超重和肥胖的女性会增加不良妊娠结局的风险。特别是，肥胖妇女患妊娠期糖尿病、妊娠高血压综合征和先兆子痫的风险增加。迫切需要有效的预防策略。当前对照试验ISRCTN00416244
The prevalence of obesity amongst women bearing children in Australia is rising and has important implications for obstetric care. The aim of this study was to assess the prevalence and impact of mothers being overweight and obese in early to mid-pregnancy on maternal, peripartum and neonatal outcomes. A secondary analysis was performed on data collected from nulliparous women with a singleton pregnancy enrolled in the Australian Collaborative Trial of Supplements with antioxidants Vitamin C and Vitamin E to pregnant women for the prevention of pre-eclampsia (ACTS). Women were categorized into three groups according to their body mass index (BMI): normal (BMI 18.5-24.9 kg/m2); overweight (BMI 25-29.9 kg/m2) and; obese (BMI 30-34.9 kg/m2). Obstetric and perinatal outcomes were compared by univariate and multivariate analyses. Of the 1661 women included, 43% were overweight or obese. Obese women were at increased risk of pre-eclampsia (relative risk (RR) 2.99 [95% confidence intervals (CI) 1.88, 4.73], p < 0.0001) and gestational diabetes (RR 2.10 [95%CI 1.17, 3.79], p = 0.01) compared with women with a normal BMI. Obese and overweight women were more likely to be induced and require a caesarean section compared with women of normal BMI (induction - RR 1.33 [95%CI 1.13, 1.57], p = 0.001 and 1.78 [95%CI 1.51, 2.09], p < 0.0001, caesarean section - RR 1.42 [95%CI 1.18, 1.70], p = 0.0002 and 1.63 [95%CI 1.34, 1.99], p < 0.0001). Babies of women who were obese were more likely to be large for gestational age (LFGA) (RR 2.08 [95%CI 1.47, 2.93], p < 0.0001) and macrosomic (RR 4.54 [95%CI 2.01, 10.24], p = 0.0003) compared with those of women with a normal BMI. The rate of overweight and obesity is increasing amongst the Australian obstetric population. Women who are overweight and obese have an increased risk of adverse pregnancy outcomes. In particular, obese women are at increased risk of gestational diabetes, pregnancy induced hypertension and pre-eclampsia. Effective preventative strategies are urgently needed. Current Controlled Trials ISRCTN00416244
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影响因子：
4.5
作者：
Bhattacharya S;Campbell DM;Liston WA;Bhattacharya S
通讯作者：
Bhattacharya S
影响因子：
7.2
作者：
Robinson, HE;O'Connell, CM;McLeod, NL
通讯作者：
McLeod, NL
影响因子：
8
作者：
Boney, CM;Verma, A;Vohr, BR
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Vohr, BR
影响因子：
4.9
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通讯作者：
van Staveren, WA
影响因子：
7.2
作者：
Crane, SS;Wojtowycz, MA;Artal, R
通讯作者：
Artal, R