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调解过程是孕产妇肥胖和剖腹产分娩的可能性之间的关联的基础
Carmen Wyss1,2, Jennifer Inauen3, Eva Cignacco1
1Applied Research and Development, Division of Midwifery, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.
孕妇的肥胖增加了剖腹产分娩的风险. 介导因素,如分娩进展缓慢和先前剖腹产的分娩显著促进了这一关联,提供了潜在的干预点.
科学领域:
- 产科和妇科 产科和妇科
- 生殖健康 生殖健康
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 肥胖与孕妇的剖腹产分娩率较高有关.
- 连接肥胖和剖腹产的潜在机制需要进一步阐明.
研究的目的:
- 评估促进孕产妇肥胖和产前/产后剖腹产之间的关联的调解因素.
主要方法:
- 追溯分析394,812个单独的头骨分娩 (2005-2020年).
- 肥胖 (BMI ≥30 kg/m2) 被定义为暴露;剖腹产作为结果.
- 使用通用结构方程建模的路径分析通过妊娠并发症,婴儿大小,妊娠持续时间,分娩进展,诱导和先前剖腹产史来评估调解.
主要成果:
- 在肥胖妇女中,剖腹产产率为39.36%,而在没有肥胖妇女中为24.12%.
- 调解模型解释了高达39.47%的肥胖-剖腹产相关性.
- 缓慢的分娩进展和剖腹产史是最重要的临床调解因素,在多胎妇女中解释了高达57.13%的情况.
结论:
- 肥胖症通过特定的介导途径增加了剖腹产分娩率.
- 优化肥胖妇女的分娩进展可能会降低剖腹产率,并防止重复剖腹产多胎妇女.
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