Neonatal and Maternal Outcomes in Nulliparous Individuals according to Prepregnancy Body Mass Index.

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY American journal of perinatology Pub Date : 2024-09-17 DOI:10.1055/a-2388-6158

Tetsuya Kawakita, Rula Atwani, George Saade

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Abstract

Objective: This study aimed to examine the effect of incremental changes in body mass index (BMI, kg/m²) on the association with adverse pregnancy outcomes.

Study design: This was a retrospective cohort study of U.S. vital statistics Live Birth and Infant Death linked data from 2011 to 2020. We limited analyses to nulliparas with singleton pregnancies who delivered at 20 weeks or greater. Outcomes were compared according to the prepregnancy BMI category using 5 kg/m² increments, with each of the other BMI categories sequentially as the referent. The composite neonatal outcome was defined as any neonatal death, neonatal intensive care unit (ICU), surfactant use, ventilation use, or seizure. Severe maternal morbidity was defined as any maternal ICU, transfusion, uterine rupture, and hysterectomy. Adjusted relative risks were calculated for each BMI category as a referent group, using modified Poisson regression and adjusting for confounders.

Results: A total of 11,174,890 nulliparous individuals were included. From 2011 to 2020, the proportions of individuals with BMI 40 or greater, BMI 50 or greater, and BMI 60 or greater increased significantly (from 3.1 to 4.9%, from 0.4 to 0.6%, from 0.03 to 0.06%, respectively; all trend p-values < 0.001). As BMI deviated from normal BMI, risks of neonatal and maternal adverse outcomes increased progressively. For example, as BMI deviated from normal BMI (18.5-24.9), the risk of composite neonatal outcome increased by 2% in individuals with BMI < 18.5 and up to 2.11-fold in individuals with BMI 65-69.9. When compared with BMI 40 to 44.9, BMI 35 to 39.9 was associated with an 8% decreased risk of composite neonatal outcome, whereas BMI 45 to 49.9 was associated with an 8% increased risk of composite neonatal outcome.

Conclusion: Incremental increases in prepregnancy BMI are linked to higher risks of adverse pregnancy outcomes, highlighting the need for effective weight management before conception.

Key points: · Incremental BMI increases raise pregnancy risks.. · Higher BMI linked to adverse neonatal outcomes.. · Elevated BMI heightens severe maternal morbidity..

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根据孕前体重指数确定无产后妇女的新生儿和产妇预后。

研究目的研究设计：这是一项回顾性队列研究，研究对象是 2011 年至 2020 年美国生命统计活产和婴儿死亡的相关数据。我们将分析对象限定为在 20 周或 20 周以上分娩的单胎非妊娠妇女。结果根据孕前 BMI 类别进行比较，以 5 kg/m2 为增量，其他 BMI 类别依次作为参照。新生儿综合结果定义为新生儿死亡、新生儿重症监护室（ICU）、表面活性物质使用、通气使用或癫痫发作。产妇重症监护室、输血、子宫破裂和子宫切除是指产妇的严重发病率。采用改良泊松回归并调整混杂因素，以每个 BMI 类别为参照组计算调整后的相对风险：共纳入了 11,174,890 名无子宫者。从 2011 年到 2020 年，体重指数大于或等于 40、体重指数大于或等于 50 和体重指数大于或等于 60 的人数比例显著增加（分别从 3.1% 增加到 4.9%、从 0.4% 增加到 0.6%、从 0.03% 增加到 0.06%；所有趋势 P 值均为结论）：孕前体重指数的递增与不良妊娠结局的风险升高有关，这凸显了在孕前进行有效体重管理的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

期刊介绍： The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.