The impact of change in pregnancy body mass index on cesarean delivery
The impact of change in pregnancy body mass index on cesarean delivery
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DOI：
10.3109/14767058.2013.845657
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发表时间：
2014-05-01
影响因子：
1.8
通讯作者：
Chung, Judith H.
中科院分区：
文献类型：
--
作者：
Swank, Morgan L.;Caughey, Aaron B.;Chung, Judith H.
目的：探讨妊娠期体重指数 (BMI) 变化对剖宫产发生率的影响。方法：这是一项回顾性队列研究，使用 2007 年以来的相关出生证明和出院诊断数据。计算剖宫产结果的调整优势比 (aOR)，作为妊娠期 BMI 分类变化 (kg/m(2)) 的函数：BMI 损失 (BMI 变化 10)。确定妊娠期 BMI 变化对整个队列的影响，然后按孕前 BMI 类别进行分层。 结果：研究人群包括 436 414 名单胎妊娠女性。与 BMI 没有净变化的女性相比，BMI 变化过度的女性的剖宫产率总体增加了 80%（aOR = 1.78）。按孕前肥胖等级划分，BMI变化过大的女性剖宫产的aOR为：正常体重（aOR = 2.25）、超重（aOR = 2.39）、肥胖I级（aOR = 2.23）、肥胖II级（aOR = 2.56）和肥胖III级（aOR = 2.08）。 结论：孕前BMI类别随着净BMI变化而增加。这些数据表明，所有女性，不仅仅是超重和肥胖的女性，在怀孕期间体重指数变化过大，剖腹产的风险显着增加。
Objective: To examine the impact of pregnancy changes in body mass index (BMI) on the incidence of cesarean delivery.Methods: This is a retrospective cohort study using linked birth certificate and discharge diagnosis data from the year 2007. Adjusted odds ratios (aOR) were calculated for the outcome of cesarean delivery, as a function of a categorical change in pregnancy BMI (kg/m(2)): BMI loss (BMI change10). The impact of pregnancy change in BMI was determined for the entire cohort and then stratified by prepregnancy BMI category.Results: The study population consisted of 436 414 women with singleton gestations. When compared to women with no net change in BMI, women with excessive BMI changes collectively had a 80% increased incidence of cesarean delivery (aOR = 1.78). By prepregnancy obesity class, the aOR for cesarean delivery in women with excessive BMI change were: normal weight (aOR = 2.25), overweight (aOR = 2.39), obese class I (aOR = 2.23), obese class II (aOR = 2.56) and obese class III (aOR = 2.08).Conclusions: The odds of cesarean delivery were uniformly increased in all prepregnancy BMI categories as net BMI change increased. These data illustrate that all women, not just the overweight and obese, are at significantly increased risk of cesarean delivery with excessive BMI change during pregnancy.