Effect of prepregnancy body mass index categories on obstetrical and neonatal outcomes
Effect of prepregnancy body mass index categories on obstetrical and neonatal outcomes
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DOI：
10.1007/s00404-006-0219-y
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发表时间：
2007-01-01
影响因子：
2.6
通讯作者：
Usher, Robert
中科院分区：
文献类型：
--
作者：
Abenhaim, Haim A.;Kinch, Robert A.;Usher, Robert
目的探讨体重指数(BMI)与产科和新生儿结局的关系。方法采用McGill产科和新生儿数据库对1987-1997年间所有分娩病例进行队列研究，比较孕前BMI与产科和新生儿结局的关系。孕前BMI分为体重不足(20)、正常(20-24.9)、超重(25-29.9)、肥胖(30-39.9)和病态肥胖(40+)。结果调查人群中体重不足4312人(23.1%)，正常体重10021人(53.8%)，超重3069人(16.5%)，肥胖1137人(6.1%)，病态肥胖104人(0.6%)。与体重指数正常的妇女相比，超重、肥胖和病态肥胖妇女患先兆子痫的风险分别增加2.28(1.88~2.77)、4.65(3.71~5.83)、6.26(3.48~11.26)，妊娠期高血压1.56(1.35~1.81)、2.01(1.64~2.45)、2.77(1.60~4.78)；妊娠期糖尿病1.89(1.63~2.19)，3.22(2.68~3.87)，4.71(2.89~7.67)，早产1.20(1.04~1.38)，1.60(1.32~1.94)，2.43(1.46~4.05)，剖宫产1.48(1.35~1.62)，1.85(1.62~2.11)，2.92(1.97~4.34)；巨大儿1.66(1.23~2.24)、2.32(1.58~3.41)、2.10(0.64~6.86)。体重不足的妇女较少发生：先兆子痫0.67(0.52~0.86)，妊娠期高血压0.71(0.60~0.83)，妊娠期糖尿病0.82(0.69~0.97)，剖宫产0.89(0.81~0.97)，肩难产0.88(0.80~0.96)，产伤0.40(0.21~0.77)，巨大儿为0.43(0.28~0.68)，小于胎龄儿为1.54(1.37~1.72)，胎儿宫内发育受限为1.33(1.07~1.67)。孕前体重指数过低与不良妊娠结局的风险降低有关。
Objectives To examine the association between body mass index (BMI) and obstetrical and neonatal outcomes.Methods We conducted a cohort study comparing prepregnant BMI categories with obstetrical and neonatal outcomes using the McGill Obstetrical and Neonatal Database on all deliveries in 10 year period (1987-1997). Prepregnant BMI was categorized into underweight (< 20), normal (20-24.9), overweight (25-29.9), obese (30-39.9), and morbidly obese (40+). Logistic regression analysis was used to adjust for age, smoking, parity, and preexisting diabetes using normal BMI as the reference.Results The population consisted of underweight 4,312 (23.1%), normal weight 10,021 (53.8%), overweight 3,069 (16.5%), obese 1,137 (6.1%), and morbidly obese 104 (0.6%). As compared to women with normal BMIs, overweight, obese, and morbidly obese women had an increased risk of preeclampsia 2.28 (1.88-2.77), 4.65 (3.71-5.83), 6.26 (3.48-11.26); gestational hypertension 1.56 (1.35-1.81), 2.01 (1.64-2.45), 2.77 (1.60-4.78); gestational diabetes 1.89 (1.63-2.19), 3.22 (2.68-3.87), 4.71 (2.89-7.67); preterm birth 1.20 (1.04-1.38), 1.60 (1.32-1.94), 2.43 (1.46-4.05); cesarean section 1.48 (1.35-1.62), 1.85 (1.62-2.11), 2.92 (1.97-4.34); and macrosomia 1.66 (1.23-2.24), 2.32 (1.58-3.41), 2.10 (0.64-6.86). Underweight women were less likely to have: preeclampsia 0.67 (0.52-0.86), gestational hypertension 0.71 (0.60-0.83), gestational diabetes 0.82 (0.69-0.97), cesarean section 0.89 (0.81-0.97), shoulder dystocia 0.88 (0.80-0.96), birth injuries 0.40 (0.21-0.77), and macrosomia 0.43 (0.28-0.68) but more likely to have small for gestational age infants 1.54 (1.37-1.72) and intrauterine growth restricted infants 1.33 (1.07-1.67).Conclusion In a large Canadian teaching hospital, increasing prepregnancy BMI category was associated with an increasing risk of adverse pregnancy outcomes. Underweight prepregnancy BMI was associated with a reduced risk of adverse pregnancy outcomes.