改善对体重指数（BMI）较高的接受引产终止妊娠者的护理

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2024-10-07 DOI:10.1016/j.contraception.2024.110584

M Fuerst, K Prewitt, B Garg, S Ramanadhan, L Han

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引用次数: 0

摘要

方法这是一项回顾性队列研究，包括 14 年间（2020 年 1 月至 2024 年 2 月）在一家学术医疗中心接受引产终止妊娠的所有单胎妊娠患者。我们的主要结果是从首次用药到胎儿排出的时间。体重指数分为四组（18.5、18.5-25、25-30 和 30）。采用 Kruskal-Wallis 检验比较各 BMI 组的中位分娩时间；采用多变量逻辑回归模型评估 BMI 与分娩时间≥24 小时的关系。其中，290 人（73.7%）的体重指数大于 25。不同体重指数类别的产妇排出胎儿的中位时间有显著差异（体重指数为 18.5 的产妇排出胎儿的时间为 9 小时，体重指数为 18.5-25 的产妇排出胎儿的时间为 12 小时，体重指数为 25-30 的产妇排出胎儿的时间为 14 小时，体重指数为 30 的产妇排出胎儿的时间为 20 小时，p<0.001）。在对产妇年龄、胎龄、剖宫产史和既往阴道分娩史进行调整后，与 BMI 值为 18.5-25 的产妇相比，BMI 值为 30 的产妇的排出时间≥24 小时的几率是后者的 6.74 倍（95%CI 为 3.24-14.00）。可能需要调整引产方案，以便为体重指数较高的患者提供公平的护理。

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IMPROVING CARE FOR INDIVIDUALS WITH HIGHER BODY MASS INDEX (BMI) UNDERGOING INDUCTION TERMINATION

Objectives

We aimed to examine the association of body mass index (BMI) with time to delivery for those undergoing induction of labor for pregnancy termination in the second or third trimester.

Methods

This is a retrospective cohort study including all patients with a singleton pregnancy undergoing induction termination at a single academic medical center over a 14-year period (1/2020-2/2024). Our primary outcome was time to fetal expulsion from the first medication given. BMI was categorized into four groups (<18.5, 18.5-25, 25-30, and >30). Kruskal-Wallis tests were used to compare median time to delivery among the BMI groups; and multivariable logistic regression models were used to assess the association of BMI with time to delivery ≥24 hours.

Results

Of the 428 charts reviewed, 393 patients met inclusion criteria. Of these, 290 (73.7%) had a BMI greater than 25. The median time to expulsion was significantly different among BMI categories (9 hours for BMI < 18.5, 12 hours for BMI 18.5-25, 14 hours for BMI 25-30, and 20 hours for individuals with BMI >30, p<0.001). After adjusting for maternal age, gestational age, history of cesarean section and prior vaginal deliveries, individuals with a BMI >30 had 6.74 times the odds (95%CI 3.24-14.00) of having a time to expulsion ≥24 hours compared to BMI 18.5-25.

Conclusions

We found individuals had a significantly longer time to delivery in second and third trimester induction terminations for patients with BMI >30. Induction protocols may need to be adjusted to provide equitable care for individuals with higher BMI.

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.