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孕期体重增加和剖腹产产生的关系在接受产妇诱导的患者中

Whitney R Bender^1,2, Rebecca F Hamm¹, Cara Dolin¹

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

American journal of perinatology

|November 16, 2023

概括

超过国家医学院 (NAM) 准则的怀孕体重增加显著增加了剖腹产的风险59%. 这种较高的风险在非孕期患者中尤为明显,突出显示妊娠期体重增加是潜在的可修改因素.

科学领域:

产科和妇科产科和妇科
孕产妇和胎儿医学孕产妇和胎儿医学
公共卫生营养公共卫生营养

背景情况:

过度的妊娠体重增加 (GWG) 是对母亲健康日益关注的问题.
国家医学院 (NAM) 的指导方针提供了基于怀孕前的体重指数 (BMI) 的GWG建议.
在指导方针以上的GWG对分娩结果的影响,特别是诱导后的剖腹产率,需要进一步调查.

研究的目的:

确定NAM指导方针以上的妊娠体重增加与接受分娩诱导的患者中剖腹产率之间的关联.
为了分析这种协会,按平价分层 (无倍数与多倍数).

主要方法:

一项前性队列研究的二次分析,其中包括1,174名怀孕前BMI和妊娠期间体重增加记录的患者.
暴露被定义为怀孕期间体重增加大于NAM指南 (WGGG) 对于患者的BMI类别.
主要结局是剖腹产;分析控制了BMI,平价,妊娠糖尿病和诱导指示.

主要成果:

患有WGGG的患者的剖腹产几率增加了59% (aOR 1.58,95% CI 1.17-2.12).
患有WGGG的无卵性患者显示剖腹产的几率明显更高 (aOR 1.50,95% CI 1.07-2.10).
在WGGG或没有WGGG的多胎患者之间,没有观察到剖腹产产率的显著差异.

结论:

超过NAM指南的孕期体重增加与剖腹产分娩的可能性增加有关.
过度GWG的无卵性妇女面临着剖腹产的更高风险.
告知患者与过度GWG相关的风险可能会鼓励患者遵守指南,从而可能降低剖腹产率.

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