孕妇肥胖对分娩结局的影响

　　【摘要】 目的 探讨孕妇肥胖对分娩结局的影响。方法 2004年1月～2005年6月在我院住院并进行阴道试产的初产妇733例，其中早孕期肥胖者[即体重指数(BMI)≥24kg/m2]203例，分娩时肥胖者(BMI≥27kg/m2)326例，观察肥胖与分娩结局的关系。结果 早孕期肥胖孕妇总产程时间、宫口扩张速度、产程异常发生率、剖宫产率、产钳助产率、巨大儿和新生儿窒息发生率与对照组比较，差异有非常显著性(P<0.01)。分娩时肥胖产妇的总产程时间、宫口扩张速度、产程异常发生率、剖宫产率、产钳助产率、巨大儿和新生儿窒息的发生率与对照组比较，差异有非常显著性(P<0.01)。结论 孕期肥胖导致宫口扩张减缓、产程异常和手术产率增加。

　　【关键词】 妊娠;分娩;肥胖;巨大儿;剖宫产

　　The influence of maternal obesity on vaginal delivery

　　YANG Chen.Department of Gynecology and Obstetrics.

　　The 81th Hospital of PLA,Nanjing 210002,China

　　【Abstract】 Objective To investigate the association of maternal obesity and vaginal delivery outcome.Methods We studied 733 nulliparas women who delivered between Jan 2004 to Jul 2005.Obesity was defined by BMI≥24 in early pregnancy and BMI ≥27 before delivery.The association of maternal obesity and vaginal delivery were observed.Results The mean duration of labor and cervical dilation rate for obese women in early pregnancy was 12.9±2.5 hours and 0.66±0.18 cm/h.The incidences of abnormal labor,cesarean section,forceps delivery,macrosomia,and birth asphyxia were 33.5%,20.7%,3.9%,29.6% and 14.8% respectively.The mean duration of labor and cervical dilation rate for obese women before delivery was 14.7±2.1 hours and 0.8±0.14 cm/h.The incidences of abnormal labor,cesarean section,forceps delivery,macrosomia,and birth asphyxia were 22.1%,15.3%,2.8%,20.9% and 10.1% respectively.The differences between obese and normal pregnant women were statistically significant(P<0.01).Conclusion Obese women were at higher risk of decreased rate of cervical dilation,abnormal stage of labor and increasing cesarean delivery.

　　【Key words】 pregnancy;delivery;obesity;macrosomia;cesarean section

　　为探讨孕妇肥胖对分娩结局的影响，本研究对我院进行阴道试产的733例初产妇进行回顾分析。现报告如下。

　　1 对象与方法

　　1.1 研究对象 2004年1月～2005年6月在我院住院分娩产妇855例，选择其中进行阴道试产的初产妇733例为研究对象。所有孕产妇均为单胎、头位。年龄21～38岁，平均(26.3±2.5)岁，妊娠37～42周，平均(38.9±1.4)周。妊娠经过正常，无妊娠合并症及并发症，无任何饮食限制。

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