Nadine Sunji, Alyssa M Hernandez, Rachel Schmidt, Amy Y Pan, Nina Ayala, Margaret H Bublitz, Anna Palatnik
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An interaction between BMI and skin incision-to-delivery time was evaluated to examine their combined effect on UA pH < 7.0.A total of 16,723 women were included across five BMI groups. Increasing BMI was associated with longer time intervals from skin incision to delivery and higher rates of UA pH < 7.0. After controlling for potentially confounding factors, all BMI groups ≥25 kg/m<sup>2</sup> were associated with longer time intervals from skin incision to delivery. Specifically, BMI groups of 40 to 49.9 and ≥50 kg/m<sup>2</sup> had skin incision-to-delivery times that were 1.30 (95% confidence interval [CI]: 1.23-1.36) and 1.44 (95% CI: 1.34-1.55) times longer, respectively, compared with BMI < 25 kg/m<sup>2</sup>. In the multivariable logistic regression, BMI group ≥50 kg/m<sup>2</sup> remained associated with higher odds of UA pH < 7.0. There was a significant interaction between BMI and time from skin incision to delivery regarding the risk of UA pH < 7.0 (<i>p</i> for the interaction term = 0.003).Maternal BMI ≥ 50 kg/m<sup>2</sup> was associated with a longer time from skin incision to infant delivery and higher odds of UA pH < 7.0. 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This analysis included women who delivered via cesarean with known BMI at delivery, skin incision-to-delivery time, and UA pH. Multivariable linear regression assessed the association between BMI and time from skin incision to infant delivery while multivariable logistic regression estimated the associations of BMI and time from skin incision to delivery with UA pH < 7.0. An interaction between BMI and skin incision-to-delivery time was evaluated to examine their combined effect on UA pH < 7.0.A total of 16,723 women were included across five BMI groups. Increasing BMI was associated with longer time intervals from skin incision to delivery and higher rates of UA pH < 7.0. After controlling for potentially confounding factors, all BMI groups ≥25 kg/m<sup>2</sup> were associated with longer time intervals from skin incision to delivery. 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引用次数: 0
摘要
目的：评估分娩时产妇体重指数（BMI）、从皮肤切开到婴儿分娩的时间和脐带动脉（UA） pH值之间的关系研究设计：这是对围产期优生评估的二次分析，这是一项多中心观察性研究，研究对象是美国2008年至2011年间分娩的产科队列。该分析纳入了已知分娩时BMI、皮肤切口至分娩时间和UA pH的剖宫产妇女。多变量线性回归评估BMI与从皮肤切口至婴儿分娩时间之间的关系，而多变量logistic回归评估BMI和皮肤切口至分娩时间与UA pH之间的关系。结果：五个BMI组共纳入16,723名妇女。体重指数的增加与皮肤切口到分娩的时间间隔较长有关，较高的UA pH 2率与皮肤切口到分娩的时间间隔较长有关。具体来说，BMI为40-49.9 kg/m2和≥50 kg/m2组的皮肤切口到分娩时间分别是BMI 2组的1.30倍（95% CI 1.23-1.36）和1.44倍（95% CI 1.34-1.55）。在多变量logistic回归中，BMI≥50 kg/m2组仍与较高的UA pH几率相关。结论：母亲BMI≥50 kg/m2与较长的皮肤切口至婴儿分娩时间和较高的UA pH几率相关
Association between Maternal Body Mass Index, Skin Incision-to-Delivery Time, and Umbilical Artery pH in Cesarean Deliveries.
To estimate the association between maternal body mass index (BMI) at delivery, time from skin incision to infant delivery, and umbilical artery (UA) pH < 7.0.This was a secondary analysis of the Assessment of Perinatal Excellence, a multicenter observational study of an obstetrical cohort of individuals who delivered between 2008 and 2011 in the United States. This analysis included women who delivered via cesarean with known BMI at delivery, skin incision-to-delivery time, and UA pH. Multivariable linear regression assessed the association between BMI and time from skin incision to infant delivery while multivariable logistic regression estimated the associations of BMI and time from skin incision to delivery with UA pH < 7.0. An interaction between BMI and skin incision-to-delivery time was evaluated to examine their combined effect on UA pH < 7.0.A total of 16,723 women were included across five BMI groups. Increasing BMI was associated with longer time intervals from skin incision to delivery and higher rates of UA pH < 7.0. After controlling for potentially confounding factors, all BMI groups ≥25 kg/m2 were associated with longer time intervals from skin incision to delivery. Specifically, BMI groups of 40 to 49.9 and ≥50 kg/m2 had skin incision-to-delivery times that were 1.30 (95% confidence interval [CI]: 1.23-1.36) and 1.44 (95% CI: 1.34-1.55) times longer, respectively, compared with BMI < 25 kg/m2. In the multivariable logistic regression, BMI group ≥50 kg/m2 remained associated with higher odds of UA pH < 7.0. There was a significant interaction between BMI and time from skin incision to delivery regarding the risk of UA pH < 7.0 (p for the interaction term = 0.003).Maternal BMI ≥ 50 kg/m2 was associated with a longer time from skin incision to infant delivery and higher odds of UA pH < 7.0. BMI differentially impacted UA pH at different skin incision-to-delivery time intervals. · Maternal BMI ≥ 25 kg/m2 was associated with longer skin incision-to-delivery times.. · Maternal BMI ≥ 50 kg/m2 was associated with higher odds of UA pH < 7.0.. · The effect of maternal BMI on UA pH varied at different skin incision-to-delivery time intervals.. · Reducing skin incision-to-delivery time may mitigate the risk of UA pH <7.0 in women with BMI ≥50.
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.
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