Cesarean deliveries and maternal weight retention.
Cesarean deliveries and maternal weight retention.
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DOI：
10.1186/s12884-017-1527-x
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发表时间：
2017-10-04
影响因子：
3.1
通讯作者：
Weiss M
中科院分区：
文献类型：
--
作者：
Kapinos KA;Yakusheva O;Weiss M
剖腹产占美国所有分娩的近三分之一，每年增加380亿美元的医疗费用。虽然剖腹产在降低孕产妇和新生儿死亡率和发病率方面有着悠久的历史，但随着时间的推移，剖腹产的使用率越来越高，这引起了公众的健康关切，要求减少剖腹产。观察证据表明，剖腹产与产妇产后体重增加有关，这可能对肥胖症的流行有重要意义。然而，以前的文献通常没有解决选择偏见的相关性，孕前体重和生殖健康与剖腹产。我们使用胎儿先露不良作为一个自然实验，因为它预测剖腹产，但与孕前体重或产妇健康无关。我们使用了2006年至2013年威斯康星州的医院管理数据（包括重要出生记录中使用的字段），以创建至少有两次分娩的母亲样本。采用倾向评分法，我们比较了因胎儿先露不良而经剖宫产分娩的母亲与经阴道分娩的母亲在第二次妊娠前的体重。我们没有发现任何证据表明第一次妊娠的剖腹产会导致更大的母亲体重，BMI或在第二次妊娠之前移动到更高的BMI分类。在考虑了孕前体重、妊娠期体重增加和分娩方式之间的相关性后，没有证据表明剖腹产和母体体重保持之间存在因果关系。
Cesarean delivery accounts for nearly one-third of all births in the U.S. and contributes to an additional $38 billion in healthcare costs each year. Although Cesarean delivery has a long record of improving maternal and neonatal mortality and morbidity, increased utilization over time has yielded public health concerns and calls for reductions. Observational evidence suggests Cesarean delivery is associated with increased maternal postpartum weight, which may have significant implications for the obesity epidemic. Previous literature, however, typically does not address selection biases stemming from correlations of pre-pregnancy weight and reproductive health with Cesarean delivery. We used fetal malpresentation as a natural experiment as it predicts Cesarean delivery but is uncorrelated with pre-pregnancy weight or maternal health. We used hospital administrative data (including fields used in vital birth record) from the state of Wisconsin from 2006 to 2013 to create a sample of mothers with at least two births. Using propensity score methods, we compared maternal weight prior to the second pregnancy of mothers who delivered via Cesarean due to fetal malpresentation to mothers who deliver vaginally. We found no evidence that Cesarean delivery in the first pregnancy causally leads to greater maternal weight, BMI, or movement to a higher BMI classification prior to the second pregnancy. After accounting for correlations between pre-pregnancy weight, gestational weight gain, and mode of delivery, there is no evidence of a causal link between Cesarean delivery and maternal weight retention.
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影响因子：
7.2
作者：
Boyle A;Reddy UM;Landy HJ;Huang CC;Driggers RW;Laughon SK
通讯作者：
Laughon SK
影响因子：
7.2
作者：
Declercq, Eugene;Barger, Mary;Heffner, Linda J.
通讯作者：
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影响因子：
7.2
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Leet, T. L.
DOI：
10.1016/0002-9378(92)91347-d
发表时间：
1992-03-01
影响因子：
9.8
作者：
HICKOK, DE;GORDON, DC;DALING, JR
通讯作者：
DALING, JR