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首页> 外文期刊>Acta Obstetricia et Gynecologica Scandinavica: Official Publication of the Nordisk Forening for Obstetrik och Gynekologi >Mortality in infants of obese mothers: Is risk modified by mode of delivery?
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Mortality in infants of obese mothers: Is risk modified by mode of delivery?

机译：肥胖母亲婴儿的死亡率：分娩方式会改变风险吗？

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Objective. To examine the association between maternal obesity and infant mortality, while including information about mode of delivery and interpregnancy weight change. Design. Register-based cohort study. Setting and population. A total of 1 199 183 singletons, including 3481 infant deaths, from the Swedish Birth Register 1992-2006. Methods. Maternal body mass index (BMI) was obtained from self-reports in early pregnancy and categorized as underweight (18.5 kg/m 2), normal-weight (18.5-24.9 kg/m 2), overweight (25-29.9 kg/m 2), obese (30-34.9 kg/m 2) and extremely obese (≥35 kg/m 2). Cox regression was used to estimate hazard ratios (95% confidence intervals). Infants of normal-weight women were the referent. Main outcome measures. Neonatal and infant mortality. Results. Infant mortality increased with increasing maternal fatness [adjusted hazard ratios 1.2 (1.1-1.3), 1.4 (1.2-1.6) and 2.1 (1.8-2.5) for overweight, obesity and extreme obesity, respectively]. When accounting for mode of delivery, neonatal mortality was increased in infants of obese and extremely obese mothers after spontaneous births [adjusted hazard ratios 1.8 (1.4-2.4) and 2.6 (1.8-4.0), respectively, after term births, and 1.4 (1.1-1.9) and 2.2 (1.5-3.3), respectively, after preterm births]. No excess risk was present for infants of obese mothers after induced term and preterm births (p-values for interaction 0.05). For post-neonatal mortality, no interaction between mode of delivery and maternal obesity was observed. In women with two subsequent pregnancies, high interpregnancy weight change 1 BMI unit (1 kg/m 2) seemed to involve a modest increase in neonatal mortality in the second infant, but only after spontaneous births [adjusted odds ratio 1.3 (0.9-1.7)]. Conclusions. Maternal obesity, especially at levels that may involve cardiometabolic morbidity, was associated with increased mortality in the offspring.
机译：目的。检查孕产妇肥胖与婴儿死亡率之间的关联，同时包括有关分娩方式和孕期体重变化的信息。设计。基于注册的队列研究。设置和人口。 1992-2006年瑞典出生登记册中共有1 199 183单身人士，包括3481婴儿死亡。方法。孕妇体重指数（BMI）来自早孕的自我报告，分为体重不足（<18.5 kg / m 2），体重正常（18.5-24.9 kg / m 2），体重超重（25-29.9 kg / m） 2），肥胖（30-34.9 kg / m 2）和极度肥胖（≥35kg / m 2）。 Cox回归用于估计危险比（95％置信区间）。体重正常的婴儿为对象。主要观察指标。新生儿和婴儿死亡率。结果。婴儿死亡率随着孕产妇肥胖的增加而增加[超重，肥胖和极度肥胖的危险比分别为1.2（1.1-1.3），1.4（1.2-1.6）和2.1（1.8-2.5）]。考虑到分娩方式，肥胖和极度肥胖的母亲在自然出生后的新生儿死亡率增加了[足月出生后分别调整的危险比分别为1.8（1.4-2.4）和2.6（1.8-4.0），以及1.4（1.1） -1.9）和2.2（1.5-3.3）]。肥胖母亲的婴儿在诱导足月和早产后没有额外的风险（交互作用的p值<0.05）。对于新生儿出生后的死亡率，未观察到分娩方式与孕妇肥胖之间的相互作用。在随后两次怀孕的妇女中，高的孕期体重变化> 1 BMI单位（1 kg / m 2）似乎在第二个婴儿中适度增加了新生儿死亡率，但仅在自然出生后才发生[校正比值比1.3（0.9-1.7） ）]。结论孕妇肥胖，尤其是可能涉及心脏代谢疾病的肥胖，与后代死亡率增加有关。

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