Andrew J Goldsack, Melvin B Marzan, Daniel L Rolnik, Anthea C Lindquist, Joanne M Said, Kirsten R Palmer, Penelope M Sheehan, Stephanie Potenza, Natasha Pritchard, Clare L Whitehead, Jolyon Ford, Ben W Mol, Susan P Walker, Lisa Hui
{"title":"大流行期间初产妇体重指数、巨大儿和剖腹产的趋势：墨尔本 12 家公立医院的多中心回顾性队列研究。","authors":"Andrew J Goldsack, Melvin B Marzan, Daniel L Rolnik, Anthea C Lindquist, Joanne M Said, Kirsten R Palmer, Penelope M Sheehan, Stephanie Potenza, Natasha Pritchard, Clare L Whitehead, Jolyon Ford, Ben W Mol, Susan P Walker, Lisa Hui","doi":"10.1186/s12884-024-06908-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare specific perinatal outcomes in nulliparas with a singleton infant in cephalic presentation at term, with and without exposure to the COVID-19 pandemic during pregnancy. We hypothesised that the pandemic conditions in Melbourne may have been an independent contributor to trends in maternal Body Mass Index ≥ 25 kg/m<sup>2</sup>, macrosomia and caesarean section.</p><p><strong>Design: </strong>Multi-centre retrospective cohort study and interrupted time-series analysis.</p><p><strong>Setting: </strong>Metropolitan Melbourne, Victoria.</p><p><strong>Population: </strong>Singleton infants ≥ 20 weeks gestational age born between 1 January 2019 and 31 March 2022.</p><p><strong>Main outcome measures: </strong>Rates of maternal Body Mass Index ≥ 25 kg/m<sup>2</sup>, macrosomia (birthweight ≥ 4000 g) and caesarean section.</p><p><strong>Results: </strong>25 897 individuals gave birth for the first time to a singleton infant in cephalic presentation at term in the pre-pandemic cohort, and 25 298 in the pandemic-exposed cohort. Interrupted time-series analysis demonstrated no significant additional effect of the pandemic on pre-existing upward trends in maternal Body Mass Index ≥ 25 kg/m<sup>2</sup>, caesarean section or macrosomia. The rate of maternal Body Mass Index ≥ 25 kg/m<sup>2</sup> was higher in the pandemic-exposed cohort compared with the pre-pandemic cohort, (45.82% vs. 44.58% respectively, p = 0.041) as was the overall rate of caesarean section (33.09% vs. 30.80%, p < 0.001). However, this increase in caesarean section was confined to individuals who had either an induction of labour or no labour. There was also a nonsignificant trend to higher rates of macrosomia in the pandemic-exposed cohort compared with the pre-pandemic cohort (8.55% vs. 7.99% respectively, p = 0.124).</p><p><strong>Conclusions: </strong>While rates of Body Mass Index ≥ 25 kg/m<sup>2</sup>, pre-labour caesarean section, and caesarean section following induction of labour were higher among pandemic-exposed nulliparas, these findings represented a continuation of pre-existing upward trends, with no significant independent contribution from the pandemic. These trends are forecast to continue, with long term implications for population health.</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"24 1","pages":"706"},"PeriodicalIF":2.8000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514852/pdf/","citationCount":"0","resultStr":"{\"title\":\"Trends in maternal body mass index, macrosomia and caesarean section in first-time mothers during the pandemic: a multicentre retrospective cohort study of 12 Melbourne public hospitals.\",\"authors\":\"Andrew J Goldsack, Melvin B Marzan, Daniel L Rolnik, Anthea C Lindquist, Joanne M Said, Kirsten R Palmer, Penelope M Sheehan, Stephanie Potenza, Natasha Pritchard, Clare L Whitehead, Jolyon Ford, Ben W Mol, Susan P Walker, Lisa Hui\",\"doi\":\"10.1186/s12884-024-06908-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare specific perinatal outcomes in nulliparas with a singleton infant in cephalic presentation at term, with and without exposure to the COVID-19 pandemic during pregnancy. We hypothesised that the pandemic conditions in Melbourne may have been an independent contributor to trends in maternal Body Mass Index ≥ 25 kg/m<sup>2</sup>, macrosomia and caesarean section.</p><p><strong>Design: </strong>Multi-centre retrospective cohort study and interrupted time-series analysis.</p><p><strong>Setting: </strong>Metropolitan Melbourne, Victoria.</p><p><strong>Population: </strong>Singleton infants ≥ 20 weeks gestational age born between 1 January 2019 and 31 March 2022.</p><p><strong>Main outcome measures: </strong>Rates of maternal Body Mass Index ≥ 25 kg/m<sup>2</sup>, macrosomia (birthweight ≥ 4000 g) and caesarean section.</p><p><strong>Results: </strong>25 897 individuals gave birth for the first time to a singleton infant in cephalic presentation at term in the pre-pandemic cohort, and 25 298 in the pandemic-exposed cohort. Interrupted time-series analysis demonstrated no significant additional effect of the pandemic on pre-existing upward trends in maternal Body Mass Index ≥ 25 kg/m<sup>2</sup>, caesarean section or macrosomia. The rate of maternal Body Mass Index ≥ 25 kg/m<sup>2</sup> was higher in the pandemic-exposed cohort compared with the pre-pandemic cohort, (45.82% vs. 44.58% respectively, p = 0.041) as was the overall rate of caesarean section (33.09% vs. 30.80%, p < 0.001). However, this increase in caesarean section was confined to individuals who had either an induction of labour or no labour. There was also a nonsignificant trend to higher rates of macrosomia in the pandemic-exposed cohort compared with the pre-pandemic cohort (8.55% vs. 7.99% respectively, p = 0.124).</p><p><strong>Conclusions: </strong>While rates of Body Mass Index ≥ 25 kg/m<sup>2</sup>, pre-labour caesarean section, and caesarean section following induction of labour were higher among pandemic-exposed nulliparas, these findings represented a continuation of pre-existing upward trends, with no significant independent contribution from the pandemic. These trends are forecast to continue, with long term implications for population health.</p>\",\"PeriodicalId\":9033,\"journal\":{\"name\":\"BMC Pregnancy and Childbirth\",\"volume\":\"24 1\",\"pages\":\"706\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-10-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514852/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Pregnancy and Childbirth\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12884-024-06908-y\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Pregnancy and Childbirth","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12884-024-06908-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Trends in maternal body mass index, macrosomia and caesarean section in first-time mothers during the pandemic: a multicentre retrospective cohort study of 12 Melbourne public hospitals.
Objective: To compare specific perinatal outcomes in nulliparas with a singleton infant in cephalic presentation at term, with and without exposure to the COVID-19 pandemic during pregnancy. We hypothesised that the pandemic conditions in Melbourne may have been an independent contributor to trends in maternal Body Mass Index ≥ 25 kg/m2, macrosomia and caesarean section.
Design: Multi-centre retrospective cohort study and interrupted time-series analysis.
Setting: Metropolitan Melbourne, Victoria.
Population: Singleton infants ≥ 20 weeks gestational age born between 1 January 2019 and 31 March 2022.
Main outcome measures: Rates of maternal Body Mass Index ≥ 25 kg/m2, macrosomia (birthweight ≥ 4000 g) and caesarean section.
Results: 25 897 individuals gave birth for the first time to a singleton infant in cephalic presentation at term in the pre-pandemic cohort, and 25 298 in the pandemic-exposed cohort. Interrupted time-series analysis demonstrated no significant additional effect of the pandemic on pre-existing upward trends in maternal Body Mass Index ≥ 25 kg/m2, caesarean section or macrosomia. The rate of maternal Body Mass Index ≥ 25 kg/m2 was higher in the pandemic-exposed cohort compared with the pre-pandemic cohort, (45.82% vs. 44.58% respectively, p = 0.041) as was the overall rate of caesarean section (33.09% vs. 30.80%, p < 0.001). However, this increase in caesarean section was confined to individuals who had either an induction of labour or no labour. There was also a nonsignificant trend to higher rates of macrosomia in the pandemic-exposed cohort compared with the pre-pandemic cohort (8.55% vs. 7.99% respectively, p = 0.124).
Conclusions: While rates of Body Mass Index ≥ 25 kg/m2, pre-labour caesarean section, and caesarean section following induction of labour were higher among pandemic-exposed nulliparas, these findings represented a continuation of pre-existing upward trends, with no significant independent contribution from the pandemic. These trends are forecast to continue, with long term implications for population health.
期刊介绍：
BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.
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