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在双胞胎怀孕中,母亲肥胖和胎儿产妇结果之间的关联

Leandra Nagler¹, Carmen Eißmann², Marita Wasenitz²

¹Goethe University Frankfurt am Main, Frankfurt, Hessen, Germany.

|July 10, 2024

概括

孕产妇超重和肥胖显著增加了妊娠糖尿病和双胞胎怀孕中产前的风险,随着肥胖水平的增加,风险逐渐增加. 胎儿的结果没有受到显著的影响.

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
公共卫生公共卫生

背景情况:

全球超重和肥胖的患病率正在上升,同时伴随着双胞胎生育率的增加.
在超重和肥胖妇女的单胎和双胎怀孕中记录了对胎儿和母亲的不良结果.
世卫组织定义的肥胖水平对双胞胎怀孕结果的具体影响需要进一步调查.

研究的目的:

调查母亲妊娠前身体质量指数 (BMI) 类别与双胞胎怀孕中胎儿与母亲的结果之间的关联.
确定母亲超重和肥胖程度的增加是否与更高的不良妊娠结果发生率相关.

主要方法:

对2,349例双胞胎怀孕 (2005-2020) 的回顾性队列研究.
根据妊娠前的BMI,将母亲分为正常体重,超重和肥胖等级I,II,III.
多变量逻辑回归分析了结果:孕期糖尿病,孕前,产后出血,子宫内胎儿死亡和低Apgar分数.

主要成果:

妊娠糖尿病的调整几率比率随着BMI逐渐增加:1.47 (超重),2.79 (肥胖I),4.05 (肥胖II),6.40 (肥胖III).
孕产妇的BMI与孕前风险有显著的关联 (OR1.04).
超重或肥胖对产后出血,胎儿死亡或低Apgar分数没有显著影响.

结论:

在双胞胎怀孕中,母亲的超重和肥胖显著增加了妊娠糖尿病和子宫前的风险.
这些疾病的风险随着母亲肥胖率的上升而逐渐增加.
虽然胎儿的结果没有受到不利影响,但在双胞胎妊娠中,母亲的代谢和高血压并发症因双胞胎妊娠中的母体脂肪增加.

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