تأثير مشعر كتلة الجسم الوالدي قبل الحمل على نتائج الحمل

Authors

  • لؤي حسن

Abstract

مقدمة: يؤثر مشعر كتلة الجسم (Body Mass index) (BMI) عند الحامل بشكلٍ كبيرٍ على محصول الحمل الوالدي و الوليدي .

هدف البحث : دراسة تأثير BMI الوالدي ما قبل الحملي على النتائج السيئة للحمل ( للأم و الوليد) لدى عينة من السيدات الحوامل السوريات .

المواد و الطرق : شملت هذه الدراسة المستقبلية 200 حامل بعمر حملي أقل من 12 أسبوع من المراجعات لقسم العيادات الخارجية أو المقبولات في قسم التوليد و أمراض النساء في مشفى تشرين الجامعي , اللاذقية , في الفترة الممتدة ما بين آب 2017 – آب 2018 . تمت متابعة الحوامل حتى نهاية الحمل لتحديد نتائج الحمل الوالدية و الوليدية . تمّ تصنيف المشاركات في البحث إلى 4 فئات حسب قيمة BMI: ناقص الوزن (BMI > 18.5 كغ/م2) طبيعي الوزن(BMI  18.5 – 24.9 كغ/م2 ) ,  زائد الوزن (BMI : 25- 29.9 كغ/م2 ) , و بدين(BMI < 30 كغ/م2) . تم استخدام الانحدار اللوجستي لضبط العوامل المتداخلة . جرى تقييم النتائج الحملية الوالدية و الوليدية باستخدام نسبة الأرجحية (OR) و بفواصل ثقة (CI) 95% .

النتائج : كانت نسب توزع المرضى حسب قيمةBMI  على الشكل التالي : ناقص الوزن (5%), طبيعي الوزن (63%), زائد الوزن (18%), و بدين (14%) . بالمقارنة مع الحوامل مع وزن طبيعي , فقد وجدنا ازدياداً لدى الحوامل زائدات الوزن و البدينات في خطر حدوث الاختلاطات الحملية التالية  حيث تم التعبير عنها ]بنسبة الأرجحية (OR) و فاصل ثقة 95% [ على الترتيب : ما قبل الإرجاج  [5.45 (1.6–18.5), 4.8 (1.5–15.4)] , السكري الحملي [6.6 (1.6–26.6),4.9 (1.2–19.4)]  انبثاق الأغشية الباكر[4 (1–16.1) , 3.9 (1.06–14.3)] , الولادة القيصرية   [2.7 (1.18–6.4), 2.28 (1.04–4.9) ] , النزف بعد الولادة [4.3 (1.2-15.4),4(1.2 – 13.2)] , وليد كبير بالنسبة لعمر الحمل [4(1.2 – 12.7), 3.5(1.9-10.2)] .

كان صغر الوليد بالنسبة لعمر الحمل (17.5 CI95% : 2.9 - 103) , انفكاك المشيمة (7.6 CI95% : 1.2 – 48.1) , والولادة الباكرة (7.2 CI95% : 1.2 – 20.2) أكثر شيوعاً و بفارقٍ هامٍ لدى مجموعة الحوامل ناقصات الوزن .

الخلاصة : يترافق ازدياد BMI الوالدي مع العديد من نتائج الحمل السيئة . يزيد نقص الوزن الوالدي من خطر كلٍّ من الحصول

Introduction: Maternal body mass index (BMI) has an impact on maternal and fetal pregnancy outcome.

Aim : To investigate the effect of pre-pregnancy BMI on adverse maternal and neonatal outcomes in a sample of Syrian pregnant women attending Tishreen University Hospital .

Materials and Methods: This was a prospective study. Total of 200 pregnant women who were less than 12 weeks gestational age and receiving prenatal care at outpatient clinic or admitted to Department of Obstetrics and Gynecology Tishreen university Hospital , Lattakia ,Syria , from August 2017 to August 2018 were enrolled in the present study and monitored until delivery to establish maternal and neonatal outcome.  The subjects were categorized into four groups by BMI : underweight (BMI < 18.5 kg/m2), normal (BMI 18.5–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2) and obese (BMI ≥ 30 kg/m2).

Logistic regression was used to adjust the potential confounder. Maternal and neonatal outcomes were evaluated with odds ratio and 95% confidence intervals.

Results : 5% , 63% , 18%, and14 % of the subjects were underweight, normal BMI, overweight and obese, respectively. Compared with women of normal BMI, the risk of the following outcomes was significantly increased in overweight and obese women and expressed as [OR (95% confidence interval)] respectively:  pre-eclampsia [4.8 (1.5–15.4), 5.45 (1.6–18.5)]; gestational diabetes [4.9 (1.2–19.4), 6.6 (1.6–26.6)]; premature rupture of the membranes(PROM) [3.9 (1.06–14.3), 4 (1–16.1)]; cesarean section    [2.28 (1.04–4.9),2.7 (1.18–6.4)];

postpartum hemorrhage [4 (1.2–13.2), 4.3 (1.2– 15.4)]; large-for-gestational age [3.5 (1.9–10.2), 4(1.2–12.7)].

However, small for gestational age (17.5,2.9 –103) , abruption placentae  (7.6 , 1.2 – 48.1) , and preterm delivery (7.2 , 1.2 – 20.2) were significantly more common in the underweight group.

Conclusion :Increased maternal BMI is associated with many adverse pregnancy outcomes. Maternal underweight increases the risk of having small-for-gestational age baby, abruption placentae  and preterm delivery .

References

WHO Global Database on Body Mass Index Available at http://apps.who.int/bmi/index.jsp

World Health Organization. Obesity and overweight fact sheet (number 311). Accessed October 10, 2015. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/. Published January, 2015.

Dodd JM, Grivell RM, Nguyen AM, et al. Maternal and perinatalhealth outcomes by body mass index category. Aust N Z J Obstet Gynaecol 2011;51(2):136–140.

Bhattacharya S, Campbell DM, Liston WA, Bhattacharya S. Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health 2007; 7: 186-91

Ng SW, Zaghloul S, Ali HI, Harrison G, Popkin BM. The prevalence and trends of overweight, obesity and nutrition-related non-communicable diseases in the Arabian Gulf States. Obes Rev Off J Int Assoc Study Obes. 2011 Jan; 12(1):1±13.

Zhang CH, Liu XY, Zhan YW, Zhang L, Huang YJ, Zhou H. Effects of Prepregnancy Body Mass Index and Gestational Weight Gain on Pregnancy Outcomes. Asia-Pac J Public Health Asia-Pac Acad Consort Public Health. 2015 Sep; 27(6):620±30.

Cho E-H, Hur J, Lee K-J. Early Gestational Weight Gain Rate and Adverse Pregnancy Outcomes in Korean Women. PloS One. 2015; 10(10):e0140376.

Mamun AA, Kinarivala M, O'Callaghan MJ, Williams GM, Najman JM, Callaway LK. Associations of excess weight gain during pregnancy with long-term maternal overweight and obesity: evidence from 21 y postpartum follow-up. Am J Clin Nutr. 2010 May; 91(5):1336±41.

McDonald SD, Han Z, Mulla S, Beyene J, Knowledge Synthesis Group. Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses. BMJ. 2010; 341:c3428.

Yang S, Zhou A, Xiong C, Yang R, Bassig BA, Hu R, et al. Parental Body Mass Index, Gestational Weight Gain, and Risk of Macrosomia: a Population-Based Case-Control Study in China. Paediatr Perinat Epidemiol. 2015 Sep; 29(5):462±71.

Terada M, Matsuda Y, Ogawa M, Matsui H, Satoh S. Effects of maternal factors on birth weight in Japan. J Pregnancy. 2013; 2013:172395.

Saereepomcharenkul K. Correlation of BMI to pregnancy outcomes in Thai women delivered in Rajavithi Hospital. J Med Assoc Thai 2011; 94: S52–S58.

Hauger MS, Gibbons L, Vik T, Belizan JM. Prepregnancy weight status and the risk of adverse pregnancy outcome. Acta Obstet Gynecol Scand 2008; 87: 953–959.

Nucci LB, Schmidt MI, Duncan BB, Fuchs SC, Fleck ET, Britto MMS. Nutritional status of pregnant women: prevalence and associated pregnancy outcomes. Rev Saude Publica 2001; 35: 502–507.

MARIT S. HAUGER et al . Prepregnancy weight status and the risk of adverse pregnancy outcome . Acta Obstetricia et Gynecologica. 2008; 87: 953_959

Xuemin Liu , Juan Du , Guixi Wang , Zhenyu Chen , Wei Wang , Qi Xi . Effect of pre-pregnancy body mass index on adverse pregnancy outcome in north of China . Arch Gynecol Obstet (2011) 283:65–70

R Scott-Pillai, D Spence, CR Cardwell, A Hunter, VA Holmes . The impact of body mass index on maternal and neonatal outcomes: a retrospective study in a UK obstetric population, 2004–2011. UK obstetric population, 2004–2011. BJOG 2013;120:932–939.

Xin Y. Foo,Ristan M. Greer, and Sailesh Kumar . Impact of Maternal Body Mass Index on Intrapartum and Neonatal Outcomes in Brisbane, Australia, 2007 to 2013 . Int J Obes Relat Metab Disord 2016;25(8):1175–1182.

O’Brien TE, Ray JG, Chan WS (2003) Maternal body mass index and the risk of preeclampsia: a systematic review. Epidemiology 14:368–374

Torloni MR, Betran AP, Horta BL, Nakamura MU, Atallah AN, Moron AF, Valente O (2009) Prepregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta-analysis. Obes Rev 10(2):194–20

Bastani P, Hamdi K, Najafi H (2008) Risk factors for preeclampsia in multigravida women. Res J Biol Sci 3(1):148–153

Denison FC, Price J, Graham C et al (2008) Maternal obesity, length of gestation, risk of postdates pregnancy and spontaneous onset of labour at term. BJOG 115:720–725

NJ Sebire , M Jolly, JP Harris, J Wadsworth, M Joffe, RW Beard, L Regan and S Robinson . Maternal obesity and pregnancy outcome: a study of 287 213 pregnancies in London . International Journal of Obesity (2001) 25, 1175–1182

Haim A. Abenhaim , Robert A. Kinch , Lucie Morin , Alice Benjamin , Robert Usher . EVect of prepregnancy body mass index categories on obstetrical and neonatal outcomes . Arch Gynecol Obstet (2007) 275:39–43

Klimaviciute A, Calciolari J, Bertucci E, Abelin-Tornblomm S, Stjernhholm-Vladic Y, Bystrom B, Petraglia F, Ekman-Ordeberg G (2006) Corticotropin-releasing hormone, its binding protein and receptors in human cervical tissue at preterm and term labor in comparison to non-pregnancy state. Reprod Biol Endocrinol 31:4–29

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2018-12-27

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1.
حسن ل. تأثير مشعر كتلة الجسم الوالدي قبل الحمل على نتائج الحمل. Tuj-hlth [Internet]. 2018Dec.27 [cited 2024Apr.24];40(6). Available from: https://journal.tishreen.edu.sy/index.php/hlthscnc/article/view/5782

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Vol. 40 No. 6 (2018): العلوم الصحية

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