The influence of obesity and diabetes on the risk of cesarean delivery
The influence of obesity and diabetes on the risk of cesarean delivery
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DOI：
10.1016/j.ajog.2004.06.057
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发表时间：
2004-09-01
影响因子：
9.8
通讯作者：
Mercer, BM
中科院分区：
文献类型：
--
作者：
Ehrenberg, HM;Durnwald, CP;Mercer, BM
目的：确定妊娠前肥胖和糖尿病对剖宫产（CD）风险的影响。研究设计：从1997年1月至2001年6月，对估计胎龄为23周或更长的单胎妊娠妇女进行分娩试验，并根据妊娠前体重指数进行分类（体重不足[< 19.8 kg/m2]，正常[19.8-25 kg/m2]，超重[25.1-30 kg/m2]，肥胖[>30 kg/m2]）。糖尿病（DM）分为妊娠期、饮食调整（A1 GDM）或胰岛素治疗（A2 GDM）和妊娠前（PDM）。排除既往CD。在按估计胎龄（足月、早产、总胎龄）分层的单变量分析中比较各组的CD发生率。检查的其他变量包括DM、巨大儿（出生体重4500 g或以上）、引产和产次。多元回归包括预测糖尿病和肥胖对CD风险影响的重要变量。结果：评估了12，303例分娩记录（肥胖：2828例[22.9%];超重：2605例[21.2%]; A1 GDM：270例[2.2%]; A2 GDM：93例[0.8%]; PDM：126例[1%]）。肥胖和超重的受试者与正常受试者相比有更高的CD风险（13.8%和10.4%对7.7%，P
Objective: To determine the influence of pregravid obesity and diabetes on cesarean delivery (CD) risk.Study design: Women with singleton pregnancies of 23 weeks or more estimated gestational age who were undergoing a trial of labor January 1997 through June 2001 were categorized by pregravid body mass index (underweight [< 19.8 kg/m(2)], normal [19.8-25 kg/m(2)], overweight [25.1-30 kg/m(2)], obese [>30 kg/m(2)]). Diabetes (DM) was divided into categories of gestational, treated with diet modification (A1GDM) or insulin (A2GDM), and pregestational (PDM). Prior CDs were excluded. CD rates for each group were compared in univariate analyses stratified by estimated gestational age (term, preterm, total). Other variables examined included DM, macrosomia (birth weight 4500 g or more), induction, and parity. Multiple regression included significant variables to predict the influence of diabetes and obesity on CD risk.Results: Records for 12,303 deliveries were evaluated (obese: 2828 [22.9%]; overweight: 2605 [21.2%]; A1GDM: 270 [2.2%]; A2GDM: 93 [0.8%]; PDM: 126 [1%]). Obese and overweight subjects had a higher risk for CD, compared with normal subjects (13.8% and 10.4% versus 7.7% P