Obesity and pregnancy--a risk profile.
Obesity and pregnancy--a risk profile.
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DOI：
10.1055/s-2008-1076995
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发表时间：
2008-12-01
影响因子：
0.7
通讯作者：
Briese, V
中科院分区：
文献类型：
--
作者：
Voigt, M;Straube, S;Briese, V
目的：我们的目的是说明孕妇怀孕期间肥胖与孕妇和胎儿结局之间的关系。我们研究的影响，母亲体重指数在怀孕的风险，怀孕和分娩的开始，对身体分类的新生儿。材料和方法：在我们的回顾性队列研究中，我们包括499,267单胎妊娠从德国围产期统计1998年至2000年。51，506名肥胖孕妇（BMI ≥ 30）与320，148名正常体重孕妇（BMI 18.50-24.99）进行了比较。我们将肥胖分为3个BMI类别：BMI = 30.00-34.99，BMI = 35.00-39.99和BMI >或= 40.00。我们根据出生体重指数定义小于胎龄儿（SGA）、适于胎龄儿（阿加）和大于胎龄儿（LGA）状态。结果：所有孕妇中10.3%的BMI ≥ 30.00，0.8%的BMI ≥ 40.00。高血压的发生率随着肥胖程度的增加而增加：7.1%（BMI = 30.00-34.99）、12.5%（BMI = 35.00-39.99）和18.3%（BMI ≥ 40.00），而1.2%（BMI 18.50-24.99）。头盆不称发生率为6.8%（BMI ≥ 40.00）和2.8%（BMI 18.50-24.99）。巨大儿发生率为24.8%（BMI ≥ 40.00），而对照组为7.9%。先兆子痫、妊娠期糖尿病和胎儿结构异常的发生率也随着母亲BMI的增加而增加。不同BMI的妇女在产次上不同，但在年龄上没有差异。结论：妊娠期肥胖与一系列母亲和胎儿的不良结局有关。因此，肥胖妇女的妊娠需要密切监测和仔细计划分娩。应考虑孕前体重减轻。
AIM: We aimed to illustrate the relationship between maternal obesity during pregnancy and maternal and fetal outcomes. We examined the influence of maternal BMI at the beginning of pregnancy on risks of pregnancy and birth, and on the somatic classification of the neonates.MATERIAL AND METHODS: In our retrospective cohort study we included 499,267 singleton pregnancies taken from the German perinatal statistics of 1998-2000. 51,506 obese pregnant women (BMI >or= 30) were compared to 320,148 pregnant women of normal weight (BMI 18.50-24.99). We divided obesity into 3 BMI-categories: BMI = 30.00-34.99, BMI = 35.00-39.99, and BMI >or= 40.00. We defined small-for-gestational-age (SGA), appropriate-for-gestational-age (AGA), and large-for-gestational-age (LGA) status by birth weight percentiles.RESULTS: 10.3 % of all pregnant women had a BMI >or= 30.00 and 0.8 % had a BMI >or= 40.00. The frequency of hypertension increased with the extent of obesity: 7.1 % (BMI = 30.00-34.99), 12.5 % (BMI = 35.00-39.99) and 18.3 % (BMI >or= 40.00) compared to 1.2 % (BMI 18.50-24.99). Cephalopelvic disproportion was found in 6.8 % (BMI >or= 40.00) compared to 2.8 % (BMI 18.50-24.99). Fetal macrosomia occurred in 24.8 % (BMI >or= 40.00) compared to 7.9 % in the control group. Rates of pre-eclampsia, gestational diabetes, and fetal structural anomalies also increased with maternal BMI. Women with different BMIs differed in parity but not in age.CONCLUSIONS: Obesity during pregnancy is associated with a range of maternal and fetal adverse outcomes. Pregnancy in obese women therefore calls for close monitoring and careful planning of delivery. Pre-conceptional weight reduction should be considered.