Abstract:
INTRODUCTION:Data from the World Health Organization (WHO) demonstrates an increasing prevalence of obesity in Western countries. This study investigates the influence of obesity on the mode of delivery and the occurrence of hypoglycemia in newborns. MATERIALS AND METHODS:A retrospective analysis of all deliveries at the Department of Gynecology and Obstetrics of the University of Lübeck, Germany was conducted over a period of eleven years with the primary outcome as non-elective C-sections and hypoglycemia of newborns from obese mothers. Patients were divided into six subgroups according to WHO weight classifications as follows: control group body mass index (BMI) 18.5 - 24.9 kg/m 2 , n = 7712; general obesity BMI ≥ 25 kg/m 2 , n = 4227; overweight BMI 25 - 29.9 kg/m 2 , n = 2628; obesity I° BMI 30 - 34.9 kg/m 2 , n = 1017; obesity II° BMI 35 - 39.9 kg/m 2 , n = 370; obesity III° BMI ≥ 40 kg/m 2 , n = 212. RESULTS:Analysis of the primary outcome shows an increased incidence of non-elective C-sections with an elevated BMI (general obesity vs. control group: 20.5 vs. 15.9%, p < 0.001; OR 1.3; 95% CI 1.2 - 1.4) and elevated rates of neonatal hypoglycemia in newborns of obese mothers (general obesity vs. control group: 0.6 vs. 0.3%, p < 0.05; OR 1.8; 95% CI 1.0 - 3.0). CONCLUSIONS:Obesity is an essential obstetric risk factor. Obese women face an increased risk of non-elective C-sections, and newborns of obese mothers suffer from elevated rates of hypoglycemia. :Einleitung Nach Daten der Weltgesundheitsorganisation (WHO) steigt die Prävalenz von Adipositas in westlichen Ländern. Die vorliegende Studie untersucht den Einfluss von Adipositas auf den Geburtsmodus sowie auf die Hypoglykämierate der Neugeborenen. Material und Methoden Retrospektive Kohortenanalyse aller Geburten (n = 17 205) der Universitätsfrauenklinik zu Lübeck im Zeitraum von 11 Jahren. Primäres Zielkriterium: Rate an sekundären Sectiones (= nicht elektiven Sectiones) und Hypoglykämierate von Neugeborenen adipöser Mütter. Einteilung der Patientinnen in 6 verschiedene Subgruppen analog der WHO-Gewichtsklassifikation (Kontrollgruppe BMI 18,5 – 24,9 kg/m 2 , n = 7712, allgem. Übergewichtige BMI ≥ 25 kg/m 2 n = 4227, sowie nach WHO Präadipositas BMI 25 – 29,9 kg/m 2 n = 2628, Adipositas I° BMI 30 – 34,9 kg/m 2 n = 1017, II° BMI 35 – 39,9 n = 370, III° BMI ≥ 40 n = 212) mit anschließendem Vergleich bezüglich der definierten Outcomeparameter. Ergebnisse Ein Vergleich der Geburtsmodi zeigt eine steigende Häufigkeit einer sekundären Sectio mit zunehmendem Body-Mass-Index (allgem. Übergewichtige vs. Kontrollgruppe 20,5 vs. 15,9%, p < 0,001; OR 1,3; 95%-KI 1,2 – 1,4). Zudem zeigte sich eine erhöhte Rate an fetalen Hypoglykämien im adipösen Kollektiv (allgem. Übergewichtige vs. Kontrollgruppe 0,6 vs. 0,3%, p < 0,05; OR 1,8; 95%-KI 1,0 – 3,0). Diskussion Adipositas stellt einen wesentlichen geburtshilflichen und neonatalen Risikofaktor dar. Ein erhöhter mütterlicher BMI senkt die Wahrscheinlichkeit für einen Spontanpartus und das Risiko für kindliche Hypoglykämien nimmt zu.
journal_name
Geburtshilfe Frauenheilkdjournal_title
Geburtshilfe und Frauenheilkundeauthors
Neumann K,Indorf I,Härtel C,Cirkel C,Rody A,Beyer DAdoi
10.1055/s-0043-108763subject
Has Abstractpub_date
2017-05-01 00:00:00pages
487-494issue
5eissn
0016-5751issn
1438-8804pii
3367288journal_volume
77pub_type
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