Maternal superobesity and perinatal outcomes.
Maternal superobesity and perinatal outcomes.
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孕产妇超生和围产期结果。
DOI：
10.1016/j.ajog.2012.02.037
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发表时间：
2012-05
影响因子：
9.8
通讯作者：
Halloran DR
中科院分区：
文献类型：
--
作者：
Marshall NE;Guild C;Cheng YW;Caughey AB;Halloran DR
本研究的目的是确定母亲过度肥胖（体重指数[BMI]，≥50 kg/m2）与病态肥胖（BMI，40-49.9 kg/m2）或肥胖（BMI，30-39.9 kg/m2）相比对围产期结局的影响。我们对2000-2006年出生于肥胖密苏里州居民的所有活产单胎足月儿的出生记录和出院数据进行了回顾性队列研究。我们排除了严重的先天性畸形和患有糖尿病或慢性高血压的妇女。有64,272名新生儿符合研究标准，其中包括1185名超级肥胖的母亲（1.8%）。与肥胖妇女相比，过度肥胖妇女更容易发生先兆子痫（校正的相对危险度[aRR]，1.7; 95%置信区间[CI]，1.4 - 2.1）、巨大儿（aRR，1.8; 95% CI，1.3-2.5）和剖宫产（aRR，1.8; 95% CI，1.5-2.1）。几乎一半的超肥胖妇女（49.1%）通过剖宫产分娩，33.8%的超肥胖未经产妇女接受计划的初次剖宫产。与BMI较低的肥胖女性相比，BMI ≥50 kg/m2的女性发生围产期并发症的风险显著增加。
The purpose of this study was to determine the effect of maternal superobesity (body mass index [BMI], ≥50 kg/m2) compared with morbid obesity (BMI, 40–49.9 kg/m2) or obesity (BMI, 30–39.9 kg/m2) on perinatal outcomes. We conducted a retrospective cohort study of birth records that were linked to hospital discharge data for all liveborn singleton term infants who were born to obese Missouri residents from 2000–2006. We excluded major congenital anomalies and women with diabetes mellitus or chronic hypertension. There were 64,272 births that met the study criteria, which included 1185 superobese mothers (1.8%). Superobese women were significantly more likely than obese women to have preeclampsia (adjusted relative risk [aRR], 1.7; 95% confidence interval [CI], 1.4 –2.1), macrosomia (aRR, 1.8; 95% CI, 1.3–2.5), and cesarean delivery (aRR, 1.8; 95% CI, 1.5–2.1). Almost one-half of all superobese women (49.1%) delivered by cesarean section, and 33.8% of superobese nulliparous women underwent scheduled primary cesarean delivery. Women with a BMI of ≥50 kg/m2 are at significantly increased risk for perinatal complications compared with obese women with a lower BMI.