The association between body mass index and postpartum hemorrhage after cesarean delivery.
The association between body mass index and postpartum hemorrhage after cesarean delivery.
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DOI：
10.1038/s41598-023-38526-7
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发表时间：
2023-07-25
影响因子：
4.6
通讯作者：
Ahmadzia, Homa
中科院分区：
文献类型：
--
作者：
Whitley, Julia;Dazelle, Wayde;Kripalani, Shawn;Ahmadzia, Homa
我们旨在评估肥胖与剖宫产(CD)后产后出血(PPH)的关系。这是一项回溯性队列研究，使用了美国20家医院的多中心数据库。我们分析了从2015年到2019年接受CD治疗的27,708名患者。感兴趣的暴露是体重指数，主要结果是PPH(估计失血量[EBL] ≥ 1000mLPPH)。采用单因素Logistic回归分析肥胖与产程并发症的关系。使用多变量Logistic回归对任何混淆的人口统计学变量进行调整。采用Hosmer和Lemesow的目的性选择算法建立了PPH的多变量Logistic回归模型。使用STATA16.1(德克萨斯州大学站)进行分析，p ≤ 0.05被认为是显著的。体重指数对产后出血频率有显著影响(p = 0.004)。与BMI为18.5-24.9g/m2的患者相比，BMI在25-59.9g/m2之间的患者发生PPH的几率更高。与体重指数在18.5-24.9g/m2之间的患者相比，体重指数为 &> 60g/m2的患者发生产后出血的几率并未增加。肥胖与输血几率降低相关(AOR为0.73，95%CI为0.55-0.97)。总而言之，较高的BMI与产后出血相关，但CD后输血的几率较低。
We aimed to evaluate the association between obesity and postpartum hemorrhage (PPH) after cesarean delivery (CD). This was a retrospective cohort study using a multicenter database of 20 hospitals in the United States. We analyzed 27,708 patients undergoing CD from 2015 to 2019. The exposure of interest was BMI, and the primary outcome was PPH (estimated blood loss [EBL] ≥ 1000 mL). Simple logistic regression was used to evaluate the relationship between obesity and intrapartum complications. Multivariable logistic regression was used to adjust for any confounding demographic variables. Hosmer and Lemeshow’s purposeful selection algorithm was adapted to develop a multivariable logistic regression model of PPH. Analyses were conducted using STATA 16.1 (College Station, Texas) with p ≤ 0.05 considered significant. BMI exerted a significant effect on the frequency of PPH (p = 0.004). Compared to patients with BMI 18.5–24.9 kg/m2, patients with BMI between 25 and 59.9 kg/m2 had an increased odds of PPH. The odds of PPH in patients with BMI > 60 kg/m2 was not increased compared to patients with BMI 18.5–24.9 kg/m2. Obesity was associated with a decreased odds of blood transfusion (aOR 0.73, 95% CI 0.55–0.97). In conclusion, higher BMI was associated with PPH yet a lower odds of transfusion after CD.
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影响因子：
--
作者：
Bursac, Zoran;Gauss, C Heath;Williams, David Keith;Hosmer, David W
通讯作者：
Hosmer, David W
DOI：
10.1080/14767058.2020.1834533
发表时间：
2021-01-27
影响因子：
1.8
作者：
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Hiersch, Liran
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通讯作者：
Xiang, Lusha
影响因子：
8.8
作者：
GROSS, JB
通讯作者：
GROSS, JB
影响因子：
9.8
作者：
Vricella, Laura K.;Louis, Judette M.;Mercer, Brian M.
通讯作者：
Mercer, Brian M.