Abstract:

Objective　To investigate the relationship between pre-pregnancy body mass index (BMI) and pregnancy weight gain and the risk of emergency cesarean section during labor. Methods　Eighty primary monoparous women hospitalized at Ankang Maternal and Child Health Hospital from December 2020 to December 2023 were selected as the study objects. Their pregnancy period was (38.95±1.45) weeks. They were (33.28±1.34) years old. Their pre-pregnancy body weight was (57.22±10.17) kg. These women were divided into a vaginal delivery group (47 cases) and an emergency cesarean section group (33 cases) according to their delivery methods. The ages, pre-pregnancy BMI, body weights, weight gain, fasting insulin levels, fasting blood glucose levels, total cholesterol levels, glycated hemoglobin levels, pre-pregnancy weights, high-density lipoprotein levels, low-density lipoprotein levels, triglyceride levels, and educational levels were compared between the groups. Binary logistic regression was employed to analyze the risk factors of emergency cesarean section. Spearman's correlation analysis was conducted to evaluate the relationship of pregnancy BMI and gestational weight gain with the risk of emergency cesarean section during labor. t and χ² tests were applied. Results　The vaginal delivery group was (31.28±1.22) years old, and the emergency cesarean section group (33.78±1.44) (P<0.05). The pre-pregnancy BMI in the vaginal delivery group was (22.21 ±2.48) kg/m², and that in the emergency cesarean section group (23.39±2.33) kg/m²; the proportion of high BMI in the emergency cesarean section group was higher than that in the vaginal delivery group (P<0.05). The gestational weight gain in the vaginal delivery group was (15.11±5.18) kg, and that in the emergency cesarean section group (26.59±6.33) kg (P<0.05). The logistic regression analysis showed that older age, lower education level, higher pre-pregnancy BMI, and greater body weight increase during pregnancy were the risk factors of emergency cesarean section. The correlation analysis indicated positive correlation between BMI and emergency cesarean section (r=0.236, P<0.05), and between body weight gain and emergency cesarean section (r=0.710, P<0.05). Conclusions　Preconception BMI and weight during pregnancy were associated with emergency cesarean section. Overweight and obesity before pregnancy are risk factors for emergency cesarean section during pregnancy. Adequate weight management and health education may aid in reducing the risk of emergency cesarean section.

Key words:

Pregnancy period, BMI, Body weight gain, Emergency cesarean section, Risk

摘要：

目的　探讨孕妇孕前体重指数（BMI）、孕期体重增加量与产程中行紧急剖宫产术风险的关系。方法　选取2020年12月至2023年12月于安康市妇幼保健院住院的80例单胎初产妇作为研究对象，孕周（38.95±1.45）周，年龄（33.28±1.34）岁，孕前体重（57.22±10.17）kg。根据分娩方式将产妇分为阴道分娩组（47例）和紧急剖宫产组（33例），比较两组孕妇年龄、孕前BMI、孕期体重及增加量、空腹胰岛素、空腹血糖、总胆固醇、糖化血红蛋白、高密度脂蛋白、低密度脂蛋白、三酰甘油及受教育程度，使用二元logistic回归分析紧急剖宫产风险因素，Spearman相关性分析孕妇孕前BMI及孕期体重增加量与产程中行紧急剖宫产术风险的关系，采用t、χ²检验进行统计比较。结果　阴道分娩组年龄为（31.28±1.22）岁、孕前BMI为（22.21±2.48）kg/m²、孕期体重增加量为（15.11±5.18）kg，紧急剖宫产组分别为（33.78±1.44）岁、（23.39±2.33）kg/m²、（26.59±6.33）kg，差异均有统计学意义（均P<0.05）；logistic回归分析显示孕妇年龄大、教育程度低、孕前BMI高、孕期体重增加量多是行紧急剖宫产的风险因素；相关性分析显示，孕前BMI、体重增加量与行紧急剖宫产术呈正相关（r=0.236、r=0.710，均P<0.05）。结论　孕前BMI、孕期体重增加量与紧急剖宫产相关，孕前超重及肥胖是孕妇产程中行紧急剖宫产术的危险因素，适当的体重管理有助于降低紧急剖宫产的风险。

关键词:

妊娠期, 体重指数, 体重增加量, 紧急剖宫产, 风险