"Increasing body mass index is associated with intensive care unit admission and severe maternal morbidity".

IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Nicholas Baranco, Sameer Khan, Pamela Parker, Dimitrios S Mastrogiannis
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引用次数: 0

Abstract

Objective: This study aimed to assess the relationship between increased body mass index (BMI) with severe maternal morbidity (SMM).

Study design: We obtained data for a retrospective cohort of singleton live births using an electronic birth certificate database from 2010 to 2022 in Central New York. Institutional review board exemption was obtained. Pre-pregnancy BMI was assessed as a continuous variable and a categorical variable with groups of BMI <18.5 kg/m2, 30-39.9 kg/m2, 40-49.9 kg/m2, and ≥50 kg/m2 compared to patients with BMI 18.5-29.9 kg/m2. Primary outcomes were maternal intensive care unit (ICU) admission and composite SMM defined as ICU admission, unplanned hysterectomy, reoperation, eclampsia, and blood transfusion. Secondary outcomes were the individual SMM components, 5-minute APGAR score <7, and neonatal intensive care unit (NICU) admission. ANOVA and χ2 were used to compare continuous and categorical variables respectively, and logistic regression was used to obtain adjusted odds ratios for primary and secondary outcomes.

Results: There were 223,837 patients with singleton live births with mean BMI 27.86 kg/m2. 54,385 (24.3%) had BMI 30-39.9 kg/m2, 13,299 (5.9%) had BMI 40-49.9 kg/m2, and 1,958 (0.87%) had BMI ≥50 kg/m2. 3,203 (1.4%) patients experienced SMM, and 423 (0.2%) patients were admitted to ICU. For each 1-point increase in BMI the adjusted odds ratio (aOR) of SMM increased by 0.8% (aOR 1.008, 95% CI 1.002-1.013) and ICU admission increased by 2.0% (aOR 1.02, 95% CI 1.005-1.034). Odds of ICU admission for those with BMI 40-49.9 kg/m2 increased by 69% (aOR 1.69, 95% CI 1.16-2.47); BMI ≥50 kg/m2 increased by 300% (aOR 3.01, 95% CI 1.53-5.91), but those with BMI 30-39.9 kg/m2 did not have significantly higher odds of ICU admission (aOR 1.09, 95% CI 0.84-1.42).

Conclusion: Increasing BMI was significantly associated with increased SMM and maternal ICU admission.

“体重指数增加与重症监护病房住院和严重的孕产妇发病率有关”。
目的:探讨体重指数(BMI)升高与产妇严重发病率(SMM)的关系。研究设计:我们使用电子出生证明数据库获取2010年至2022年纽约中部单胎活产的回顾性队列数据。获得机构审查委员会的豁免。与BMI为18.5-29.9 kg/m2的患者相比,孕前BMI被评估为连续变量和分类变量,BMI为2、30-39.9 kg/m2、40-49.9 kg/m2和≥50 kg/m2组。主要结局是产妇入住重症监护病房(ICU)和复合SMM (ICU入院、非计划子宫切除术、再手术、子痫和输血)。次要结局为个体SMM成分,5分钟APGAR评分2分别用于比较连续变量和分类变量,并使用逻辑回归获得主要和次要结局的调整优势比。结果:单胎活产223,837例,平均BMI为27.86 kg/m2。BMI为30 ~ 39.9 kg/m2者54385人(24.3%),BMI为40 ~ 49.9 kg/m2者13299人(5.9%),BMI≥50 kg/m2者1958人(0.87%)。3203例(1.4%)患者出现了SMM, 423例(0.2%)患者进入了ICU。BMI每增加1点,SMM的调整优势比(aOR)增加0.8% (aOR 1.008, 95% CI 1.002-1.013), ICU入院率增加2.0% (aOR 1.02, 95% CI 1.005-1.034)。BMI 40-49.9 kg/m2患者进入ICU的几率增加69% (aOR 1.69, 95% CI 1.16-2.47);BMI≥50 kg/m2增加300% (aOR 3.01, 95% CI 1.53 ~ 5.91),但BMI为30 ~ 39.9 kg/m2的患者进入ICU的几率没有显著增加(aOR 1.09, 95% CI 0.84 ~ 1.42)。结论:BMI升高与SMM升高及产妇ICU入院率显著相关。
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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
217
审稿时长
2-3 weeks
期刊介绍: The official journal of The European Association of Perinatal Medicine, The Federation of Asia and Oceania Perinatal Societies and The International Society of Perinatal Obstetricians. The journal publishes a wide range of peer-reviewed research on the obstetric, medical, genetic, mental health and surgical complications of pregnancy and their effects on the mother, fetus and neonate. Research on audit, evaluation and clinical care in maternal-fetal and perinatal medicine is also featured.
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