The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis
The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis
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DOI：
10.1111/j.1467-789x.2008.00511.x
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发表时间：
2008-11-01
期刊：
影响因子：
8.9
通讯作者：
Summerbell, C. D.
中科院分区：
文献类型：
--
作者：
Heslehurst, N.;Simpson, H.;Summerbell, C. D.
肥胖症在产科人口中正在上升，但缺乏管理产妇肥胖症的服务和指导。这项系统性综述旨在调查肥胖与产科护理影响之间的关系。系统检索了妊娠妇女队列研究的文献，这些妇女在妊娠16周内记录了人体测量结果，随访了妊娠期，至少有一个肥胖组和一个对照组。两名研究人员独立提取数据并进行质量评估。成果计量是指直接或间接影响产妇资源的计量。主要结局包括器械分娩、剖腹产、住院时间、新生儿重症监护、新生儿创伤、出血、感染和3/4度撕裂。荟萃分析显示，肥胖与剖腹产和器械分娩、出血、感染、住院时间延长和新生儿重症监护需求增加的几率增加之间存在显著关系。产妇肥胖显着有助于在分娩期间和产后期间的母亲和婴儿的预后较差。迫切需要制定肥胖孕妇管理的国家临床指南和公共卫生干预措施，以帮助保障母亲及其婴儿的健康。
Obesity is rising in the obstetric population, yet there is an absence of services and guidance for the management of maternal obesity. This systematic review aimed to investigate relationships between obesity and impact on obstetric care. Literature was systematically searched for cohort studies of pregnant women with anthropometric measurements recorded within 16-weeks gestation, followed up for the term of the pregnancy, with at least one obese and one comparison group. Two researchers independently data-extracted and quality-assessed each included study. Outcome measures were those that directly or indirectly impacted on maternity resources. Primary outcomes included instrumental delivery, caesarean delivery, duration of hospital stay, neonatal intensive care, neonatal trauma, haemorrhage, infection and 3rd/4th degree tears. Meta-analysis shows a significant relationship between obesity and increased odds of caesarean and instrumental deliveries, haemorrhage, infection, longer duration of hospital stay and increased neonatal intensive care requirement. Maternal obesity significantly contributes to a poorer prognosis for mother and baby during delivery and in the immediate post-partum period. National clinical guidelines for management of obese pregnant women, and public health interventions to help safeguard the health of mothers and their babies are urgently required.