spontaneous premature birth のリスクが高い個体において,母親のBMI,子宮頸部長さの上昇と spontaneous premature birth の関連
Joan Crane1, Donnette O'Brien2
1Department of Obstetrics and Gynecology, Faculty of Medicine, Memorial University of Newfoundland.
まとめ
25. 0以上の母親のBMIは,高リスク妊娠における自発的な早産 (SPTB) と関連しているが,子宮頸部長さの短縮 (CL) とは関連していない. この発見は,特定の患者集団におけるSPTBのリスクを管理する上で極めて重要です.
科学分野:
- 産婦人科
- 妊婦と胎児の医療
- 生殖 健康
背景:
- 高リスク妊娠において,自発性早産 (SPTB) は大きな懸念事項です.
- 妊娠前の母親の体量指数 (BMI) と第2期子宮頸部長 (CL) は,SPTBの潜在的な指標です.
- 子宮頸部切除の手術や子宮異常が過去にあった人は,SPTBのリスクが高くなります.
研究 の 目的:
- リスクの高い妊婦の母親のBMI,短頸部長 (CL) とSPTBとの関連を調査する.
- 妊婦の第二 trimesterにおける CL に影響するかどうかを判断する.
- SPTBの予測におけるBMIとCLの独立した役割と組み合わせを明らかにする.
主な方法:
- 407人の無症状の妊婦で,単体妊娠と不変の膜を対象とした遡及的なコホート研究.
- 含有基準:SPTBのリスク増加 (子宮頸部切除術または子宮異常歴),以前のSPTB歴はありません.
- 妊娠前のBMIの評価と妊娠16週から23週間のCLのトランスヴァギナル超音波測定; ロジスティック回帰分析を使用した.
主要な成果:
- 母親のBMI> 25. 0は,妊娠37週未満のSPTBと有意に関連していた (aOR2. 65).
- 短い子宮頸部長 (CL < 2. 50 cm) は,妊娠37週未満のSPTBと強く関連していました (aOR 7. 30).
- 母親のBMI> 25. 0は,単変数または多変数解析でCL< 2. 50cmと有意に関連しませんでした.
結論:
- 子宮頸部切除術または子宮異常が既往の妊婦の場合,BMIの上昇 (> 25. 0) はSPTBの独立した危険因子です.
- 母親のBMI > 25. 0は,この高リスク集団において,第二 trimesterにおける子宮頸部長さの短縮と関連しているようには見えません.
- これらの発見は,SPTBのリスク評価において,子宮頸部長さに及ぼす潜在的な影響とは別にBMIを考慮する必要があることを示唆している.
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