The Relationship between Body Mass Index in Pregnancy and Adverse Maternal, Perinatal, and Neonatal Outcomes in Rural India and Pakistan
The Relationship between Body Mass Index in Pregnancy and Adverse Maternal, Perinatal, and Neonatal Outcomes in Rural India and Pakistan
复制标题
DOI：
10.1055/s-0037-1621733
复制
发表时间：
2018-07-01
影响因子：
2
通讯作者：
Derman, Richard J.
中科院分区：
文献类型：
--
作者：
Short, Vanessa L.;Geller, Stacie E.;Derman, Richard J.
本研究的目的是描述印度和巴基斯坦农村地区妊娠早期体重指数（BMI）与孕产妇、围产期和新生儿结局之间的关系。研究设计在巴基斯坦塔塔、印度那格浦尔和贝拉加维的社区实施了一项前瞻性、基于人群的妊娠登记，我们获得了妇女妊娠12周前的BMI（按照世界卫生组织的标准分为体重不足、正常、超重和肥胖）。结果在产后42天进行评估。结果产妇结局不良的比例随着产妇BMI的增加而增加。不到三分之一的非超重/非肥胖妇女、47.2%的超重妇女和56.0%的肥胖妇女经历了不良的产妇结局。在控制了部位、产妇年龄和胎次后，bmi越高的女性患高血压疾病/严重子痫前期/子痫、剖宫产/辅助分娩和抗生素使用的风险越高。与体重过轻/体重指数正常的妇女相比，超重妇女围产期和新生儿早期死亡的风险也明显更高。超重妇女的围产期死亡率明显较高。结论：在印度和巴基斯坦农村，妊娠早期高BMI与孕产妇、围产期和新生儿不良结局的风险增加有关。这些发现为女性在受孕前优化体重以改善妊娠结局提供了一个机会。
Objective The objective of this study was to describe the relationship between early pregnancy body mass index (BMI) and maternal, perinatal, and neonatal outcomes in rural India and Pakistan.Study Design In a prospective, population-based pregnancy registry implemented in communities in Thatta, Pakistan and Nagpur and Belagavi, India, we obtained women's BMI prior to 12 weeks' gestation (categorized as underweight, normal, overweight, and obese following World Health Organization criteria). Outcomes were assessed 42 days postpartum.Results The proportion of women with an adverse maternal outcome increased with increasing maternal BMI. Less than one-third of nonoverweight/nonobese women, 47.2% of overweight women, and 56.0% of obese women experienced an adverse maternal outcome. After controlling for site, maternal age and parity, risks of hypertensive disease/severe preeclampsia/eclampsia, cesarean/assisted delivery, and antibiotic use were higher among women with higher BMIs. Overweight women also had significantly higher risk of perinatal and early neonatal mortality compared with underweight/normal BMI women. Overweight women had a significantly higher perinatal mortality rate.Conclusion High BMI in early pregnancy was associated with increased risk of adverse maternal, perinatal, and neonatal outcomes in rural India and Pakistan. These findings present an opportunity to inform efforts for women to optimize weight prior to conception to improve pregnancy outcomes.