肥胖对妊娠结局及分娩方式的影响

 目的 了解本院分娩产妇的肥胖发病率及流行病学特点，明确肥胖产妇的妊娠结局及分娩方式。方法 选择2011年北京妇产医院住院分娩产妇共12 190例的临床资料，去除低体重样本，即孕前体重指数(body mass index，BMI)＜18.5，剩余11 628例。以孕前体重指数≥28为肥胖的诊断标准，比较肥胖组(2263例)及对照组(9365例)产妇的妊娠结局及分娩方式。结果 肥胖发病率18.6%(2263/12 190)，肥胖产妇的妊娠期高血压疾病、妊娠期糖尿病、先露异常、巨大儿、不良孕史发生风险显著高于对照组(P＜0.05)。肥胖产妇剖宫产率显著高于对照组(64.2% vs 44.0%， P＜0.05)，其中无指征剖宫产及以产程停滞、瘢痕子宫、高龄、巨大儿、骨盆狭窄、子痫前期为指征的剖宫产显著高于对照组。肥胖产妇产后出血风险显著高于对照组(P＜0.05)。结论 肥胖产妇属于高危妊娠，妊娠并发症显著增加，须加强体重管理，减少并发症的发生。

Influence of obeseity on pregnancy outcome and mode of delivery in paerperants

Objective To comparative delivery mode and perinatal outcomes in obese women compared with those with normal weight. Methods A cross sectional survey of all deliveries in Beijing Obstetrics and Gynecology Hospital from January 1 to December 31, 2011 was evaluated for demographic data and delivery outcomes. Results In this analysis of 12 190 pregnancies, 2263 (18.6%) were complicated by obesity. Compared with those with normal weight and overweight, the risks of hypertension disorder complicating pregnancy, gestational diabetes mellitus, malpresentation,and macrosomia increased significantly in obese women.The cesarean section rate was higher significantly in obese women than in women with normal weight and overweight, especially performed for maternal request, failure for progress, macrosomia, previous surgery (P<0.05). Conclusions The perinatal complications are significantly higher in obese women than in those with normal weight.