在增加自发早产风险的个体中,增加母亲的BMI,子宫长度和自发早产之间的关联
Joan Crane1, Donnette O'Brien2
1Department of Obstetrics and Gynecology, Faculty of Medicine, Memorial University of Newfoundland.
概括
孕妇的BMI超过25.0与高风险怀孕中的自发早产 (SPTB) 有关,但与宫长度短 (CL) 无关. 这一发现对于管理特定患者群体的SPTB风险至关重要.
科学领域:
- 产科和妇科
- 产妇和胎儿医学
- 生殖健康
背景情况:
- 自发早产 (SPTB) 是高风险怀孕的一个主要问题.
- 孕前母亲的体重指数 (BMI) 和第二个月的子宫长度 (CL) 是SPTB的潜在指标.
- 已有切除宫手术或子宫异常的患者患SPTB的风险增加.
研究的目的:
- 在高危孕妇中调查母亲的BMI,宫短度 (CL) 和SPTB之间的关联.
- 确定母亲的BMI是否会影响这些人怀孕的第二个三个月的CL.
- 澄清BMI和CL在预测SPTB中的独立和联合作用.
主要方法:
- 在407名无症状孕妇中进行的回顾性队列研究.
- 包括标准:SPTB的风险增加 (有切除宫手术或子宫异常史),没有先前的SPTB史.
- 在怀孕16至23周之间评估妊娠前的BMI和阴道超声波测量CL;使用后勤回归分析.
主要成果:
- 孕妇的BMI> 25. 0与妊娠37周以下的SPTB有显著的相关性 (aOR为2. 65).
- 宫长度短 (CL< 2. 50厘米) 与孕期< 37周的SPTB有很强的相关性 (aOR 7. 30).
- 在单变量或多变量分析中,母体BMI> 25. 0与CL< 2. 50 cm没有显著关联.
结论:
- 在有史以来切除宫手术或子宫异常的孕妇中,高BMI (> 25. 0) 是SPTB的独立风险因素.
- 在这一高危人群中,母亲的BMI> 25.0似乎与宫长度缩短无关.
- 这些发现表明,在SPTB的风险评估中,BMI应与其对子宫长度的潜在影响分开考虑.
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