Are overweight and obesity associated with increased risk of cesarean delivery in Mexico? A cross-sectional study from the National Survey of Health and Nutrition
Are overweight and obesity associated with increased risk of cesarean delivery in Mexico? A cross-sectional study from the National Survey of Health and Nutrition
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DOI：
10.1186/s12884-019-2393-5
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发表时间：
2019-07-11
影响因子：
3.1
通讯作者：
Darney, Blair G.
中科院分区：
文献类型：
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作者：
Brenes-Monge, Alexander;Saavedra-Avendano, Biani;Darney, Blair G.
在墨西哥，肥胖是一个主要的公共卫生问题; 71%的成年人超重或肥胖。剖腹产的比例也很高（45%）。超重或肥胖的育龄妇女可能是在更高的风险careers.Methods：我们进行了一项横断面研究，以测试超重和肥胖（使用体重指数，BMI）和剖宫产在墨西哥使用的数据之间的关联从2012年全国健康和营养调查（ENSANUT）。我们的样本包括调查时报告在2006年至2012年期间活产的育龄妇女。我们使用双变量统计和多元逻辑回归模型来检验测量的BMI和自我报告的剖宫产之间的关联。我们包括个人，临床和家庭水平的混杂因素，并使用调查权重产生populationestimation.Results：我们的样本包括4,570名妇女（人口N = 7,447,541）。总的来说，44%的妇女在最后一次分娩时报告剖宫产。我们发现BMI组的剖宫产率存在差异（正常= 39%; 95%CI [35-43];超重= 42%; 95%CI [38-45];肥胖= 52%; 95%CI [48-57]; p < 0.001）。在控制社会人口统计学和临床特征的多变量模型中，我们发现肥胖与经产妇女剖腹产之间存在强有力的独立关联，与BMI正常的经产妇女相比（肥胖aOR：1.60; 95%CI [1.21-2.12]）。结论：我们提供了关于墨西哥超重和肥胖妇女分娩比例的新证据。在墨西哥，肥胖的经产妇女比体重指数正常的经产妇女有更高的剖宫产风险。鉴于肥胖和剖腹产在墨西哥的高患病率，这种关系是突出的妇女，卫生保健提供者和卫生系统。努力降低剖腹产率需要考虑到肥胖的流行。
Background: In Mexico, obesity is a major public health problem; 71% of adults are overweight or obese. The proportion of deliveries by cesarean is also very high (45%). Women of reproductive age with overweight or obesity may be at higher risk of cesarean.Methods: We conducted a cross-sectional study to test the association between overweight and obesity (using body mass index, BMI) and cesarean delivery in Mexico using data from the 2012 National Survey of Health and Nutrition (ENSANUT). Our sample included women of reproductive age at the time of survey who reported a live birth between 2006 and 2012. We used bivariate statistics and a multivariate logistic regression model to test the association between measured BMI and self-reported cesarean delivery. We included individual, clinical, and household level confounders and used survey weights to produce population estimates.Results: Our sample consisted of 4,570 women (population N = 7,447,541). Overall, 44% of the women reported a cesarean at last delivery. We found differences in the proportion of cesarean delivery by BMI group (normal = 39%; 95% CI [35-43]; overweight = 42%; 95% CI [38-45]; obesity = 52%; 95% CI [48-57]; p < 0.001). In multivariable models controlling for socio-demographic and clinical characteristics, we found a strong and independent association between obesity and cesarean delivery among multiparous women, compared with multiparous women with normal BMI (obesity aOR: 1.60; 95% CI [1.21-2.12]).Conclusions: We provide new evidence about the proportion of women with overweight and obesity who deliver in Mexico. Multiparous women with obesity are at higher risk of cesarean delivery in Mexico than multiparous women with normal body mass index. Given the high prevalence of both obesity and cesarean delivery in Mexico, this relationship is salient for women, health care providers, and the health system.Efforts to reduce the cesarean deliveries rate need to take the obesity epidemic into account.