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体质指数和剖腹产分娩后产后出血之间的关联

Julia Whitley¹, Wayde Dazelle², Shawn Kripalani²

¹Department of Obstetrics and Gynecology, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave NW, Washington, DC, 20037, USA. jdewhitley@gmail.com.

Scientific reports

|July 25, 2023

概括

肥胖增加了剖腹产分娩后产后出血 (PPH) 的风险. 然而,较高的体重指数 (BMI) 与这些患者对输血的需求减少有关.

科学领域:

产科和妇科产科和妇科
生殖健康生殖健康
临床流行病学临床流行病学

背景情况:

肥胖是一个日益严重的公共卫生问题,可能会对怀孕结果产生影响.
剖腹产 (CD) 率在全球范围内增加,需要对相关并发症进行研究.
产后出血 (PPH) 仍然是孕产妇发病率和死亡率的重要原因.

研究的目的:

调查由身体质量指数 (BMI) 定义的肥胖症与剖腹产 (CD) 后的PPH发生之间的联系.
探索不同程度的肥胖和需要血液输血的可能性之间的关系.

主要方法:

追溯队列研究分析了2015年至2019年间在美国20家医院接受CD治疗的27,708名患者的数据.
暴露:身体质量指数 (BMI). 主要结局:PPH (估计血液损失≥1000毫升).
统计分析包括后勤回归模型,调整以混人口变量,使用STATA 16.1.1.

主要成果:

在BMI和PPH频率 (p=0.004) 之间发现了统计学上显著的关联.
与BMI为18.5-24.9 kg/m2的患者相比,BMI为25-59.9 kg/m2的患者患PPH的几率增加.
体重指数>60公斤/平方米的患者没有增加PPH的几率. 肥胖与输血几率降低有关 (aOR 0.73).

结论:

较高的BMI与剖腹产产后产后出血风险增加有显著的关联.
尽管PPH风险增加,但较高的BMI与CD后需要输血的可能性较低相关.

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