Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women - systematic review and meta-analysis of cohort studies
Obesity as an independent risk factor for elective and emergency caesarean delivery in nulliparous women - systematic review and meta-analysis of cohort studies
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DOI：
10.1111/j.1467-789x.2008.00537.x
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发表时间：
2009-01-01
期刊：
影响因子：
8.9
通讯作者：
Bhattacharya, S.
中科院分区：
文献类型：
--
作者：
Poobalan, A. S.;Aucott, L. S.;Bhattacharya, S.
该研究的目的是调查产妇体重指数（BMI）增加与择期/急诊剖腹产率之间的关系。使用了已发表队列研究的系统综述和荟萃分析。系统检索了1996年至2007年5月的文献数据库MEDLINE、EMBASE、CINAHL，无语言限制。将MeSH术语和“妊娠”、“肥胖”、“超重”、"体重指数“和”剖腹产“的关键词与科克伦协作策略相结合，以识别主要研究。最后，有11篇论文被认为符合纳入审查的条件。尽管所有论文都是队列研究，但只有3篇是前瞻性的。与BMI正常的女性相比（20-25 kg m（-2）），粗合并优势比（95%置信区间）（BMI 25-30 kg m（-2）），肥胖肥胖组（BMI 30-35 kg·m ~（-2））和病态肥胖组（BMI > 35 kg·m ~（-2））的平均体重分别为1.53（1.48，1.58）、2.26（2.04，2.51）和3.38（2.49，4.57）。超重妇女紧急剖腹产的合并几率为1.64（95%置信区间1.55，1.73），肥胖妇女为2.23（2.07，2.42）。超重妇女的剖腹产风险增加了50%，肥胖妇女的风险是BMI正常妇女的两倍多。
The objective of the study was to investigate the association between increasing maternal body mass index (BMI) and elective/emergency caesarean delivery rates. Systematic review and meta-analysis of published cohort studies were used. The bibliographic databases, MEDLINE, EMBASE, CINAHL, were searched systematically, with no language restrictions, from 1996 to May 2007. MeSH terms and key words for 'pregnancy', 'obesity', 'overweight,' 'body mass index' and 'caesarean section' were combined with the Cochrane Collaboration strategy for identifying primary studies. Finally, 11 papers were considered eligible for inclusion in the review. Although all the papers were cohort studies, only three were prospective in nature. Compared with women with normal BMI (20-25 kg m(-2)), the crude pooled odds ratios (95% confidence intervals) for caesarean section in overweight (BMI 25-30 kg m(-2)), obese (BMI 30-35 kg m(-2)) and morbidly obese (BMI > 35 kg m(-2)) women were 1.53 (1.48, 1.58), 2.26 (2.04, 2.51) and 3.38 (2.49, 4.57) respectively. The pooled odds of having an emergency caesarean section were 1.64 (95% confidence intervals 1.55, 1.73) in overweight and 2.23 (2.07, 2.42) in obese women. Caesarean delivery risk is increased by 50% in overweight women and is more than double for obese women compared with women with normal BMI.