Maternal outcomes in pregnancies complicated by obesity
Maternal outcomes in pregnancies complicated by obesity
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DOI：
10.1097/01.aog.0000188387.88032.41
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发表时间：
2005-12-01
影响因子：
7.2
通讯作者：
McLeod, NL
中科院分区：
文献类型：
--
作者：
Robinson, HE;O'Connell, CM;McLeod, NL
目的：探讨孕前肥胖与产妇结局的关系。方法：使用新斯科舍省阿特利围产期数据库进行了一项为期15年的基于人群的队列研究，比较了肥胖和非肥胖妇女的产妇结局。孕前体重55-75公斤为非肥胖，体重大于90公斤为肥胖。肥胖妇女被分为中度肥胖组（90-120公斤）和重度肥胖组（100 -120公斤）。进行单因素和多因素logistic回归分析，并计算优势比（ORs）、校正ORs和95%置信区间（Cls）。P < 0.05认为有统计学意义。结果：142404例单胎妊娠中，10134例（7.2%）女性被诊断为肥胖（中度肥胖92.3%，重度肥胖7.7%）。肥胖妇女的比例从1988年的3.2%增加到2002年的10.2%。中度肥胖妇女妊高征（PIH）（调整OR为2.38,95% Cl为2.24-2.52）、产前静脉血栓栓塞（调整OR为2.17,95% Cl为1.30-3.63）、引产（调整OR为1.94,95% Cl为1.86-2.04）、剖宫产（调整OR为1.60,95% Cl为1.53-1.67）和伤口感染（调整OR为1.67,95% Cl为1.38-2.00）的风险增加。严重肥胖妇女发生PIH（调整OR 3.00, 95% Cl 2.49-3.62）、产前静脉血栓栓塞（调整OR 4.13, 95% Cl 1.26-13.54）、引产（调整OR 2.77, 95% Cl 2.39-3.21）、剖宫产（调整OR 2.46, 95% Cl 2.15-2.81）、麻醉并发症（调整OR 2.01, 95% Cl 1.33-3.06）和伤口感染（调整OR 4.79, 95% Cl 3.30-6.95）的风险增加。这意味着，相对于非肥胖女性，每10名中度肥胖女性和7名重度肥胖女性中有1例PIH过量。对于产前静脉血栓栓塞，每857名中度肥胖妇女中有1例过量，每321名重度肥胖妇女中有1例过量。结论：孕前孕妇肥胖增加妊高征、产前静脉血栓栓塞、引产、剖宫产和伤口感染的风险。
OBJECTIVE: To investigate the relationship between prepregnancy obesity and maternal outcomes.METHODS: A 15-year, population-based cohort study using the Nova Scotia Atlee Perinatal Database compared maternal outcomes in obese and nonobese women. Prepregnancy weight of 55-75 kg was considered nonobese, and weight greater than 90 kg was considered obese. Obese women were categorized into moderate obesity (90-120 kg) and severe obesity (> 120 kg) groups. Univariate and multivariable logistic regression analysis was performed, and odds ratios (ORs), adjusted ORs, and 95% confidence intervals (Cls) were calculated. P < .05 was considered statistically significant.RESULTS: In 142,404 singleton pregnancies, 10,134 (7.2%) women were identified as obese (moderate obesity 92.3%, severe obesity 7.7%). The proportion of women in the obese categories increased from 3.2% in 1988 to 10.2% in 2002. Moderately obese women had an increased risk of pregnancy-induced hypertension (PIH) (adjusted OR 2.38, 95% Cl 2.24-2.52), antepartum venous thromboembolism (adjusted OR 2.17, 95% Cl 1.30-3.63), labor induction (adjusted OR 1.94, 95% Cl 1.86-2.04), cesarean delivery (adjusted OR 1.60, 95% Cl 1.53-1.67), and wound infection (adjusted OR 1.67, 95% C1 1.38-2.00). Severely obese women had an increased risk of PIH (adjusted OR 3.00, 95% Cl 2.49-3.62), antepartum venous thromboembolism (adjusted OR 4.13, 95% Cl 1.26-13.54), induction of labor (adjusted OR 2.77, 95% Cl 2.39-3.21), cesarean delivery (adjusted OR 2.46, 95% Cl 2.15-2.81), anesthesia complications (adjusted OR 2.01, 95% Cl 1.33-3.06), and wound infection (adjusted OR 4.79, 95% Cl 3.30-6.95). This implies that, relative to nonobese women, there was 1 excess case of PIH per 10 moderately obese women and 1 per 7 severely obese women. For antepartum venous thromboembolism, there was 1 excess case per 857 moderately obese women and 1 per 321 severely obese women.CONCLUSION: Prepregnancy maternal obesity increases the risk of PIH, antepartum venous thromboembolism, labor induction, cesarean delivery, and wound infection.