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Áhrif þyngdar verðandi mæðra á meðgöngu, fæðingu og nýbura

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Authors
Ólöf Jóna Elíasdóttir
Hildur Harðardóttir

Þórður Þórkelsson
Issue Date
2010-11-01

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Other Titles
The effect of maternal weight on pregnancy outcome
Citation
Læknablaðið 2010, 96(11):691-6
Abstract
OBJECTIVE: To examine the frequency of adverse outcome during pregnancy and delivery and neonatal complications among normal weight, overweight and obese women at the beginning of pregnancy. MATERIAL AND METHODS: The study is a retrospective cohort study of 600 women, divided in 3 groups on the basis of maternal body mass index (BMI) at the beginning of pregnancy; 300 normal weight women (BMI 19.0-24.9), 150 overweight women (BMI 25.0-29.9) and 150 obese women (BMI ≥ 30). Maternal and neonatal complications were compared between groups. RESULTS: Obese women have a significantly increased risk of; essential hypertension prior to pregnancy (p<0.001), developing gestational hypertension (p=0.03), pre-eclampsia (p=0.007), gestational diabetes (p<0.001), musculoskeletal symptoms (p=0.04), requiring induction of labour (pp=0.006) and being delivered by cesarean section (p<0.001), both emergent (pp=0.012) and elective (pp=0.008) compared to mothers of normal weight and overweight. Neonates of obese mothers have significantly higher birth weight (pp=0.004), larger head circumference (p<0.001) and are more likely to require admission to neonatal ward compared with neonates of normal weight and overweight mothers (pp=0.004). CONCLUSIONS: Obesity carries a significant risk to maternal and neonatal health. During pregnancy maternal complications are increased causing adverse effects for both mother and infant. Women of reproductive age need counselling regarding the adverse effects of obesity on pregnancy outcome.
Tilgangur: Að kanna tíðni fylgikvilla á meðgöngu, í fæðingu og hjá nýburum kvenna í kjörþyngd, of þungra og of feitra við upphaf meðgöngu. Þátttakendur og aðferðir: Rannsóknin er afturskyggn og tilfellaviðmiðuð. Upplýsingum um þyngd við upphaf meðgöngu var safnað hjá 600 konum; þar af voru 300 í kjörþyngd (þyngdarstuðull (ÞS) 19,0-24,9), 150 of þungar (ÞS 25,0-29,9) og 150 of feitar (ÞS ³30). Tíðni fylgikvilla var borin saman milli hópanna. Niðurstöður: Of feitar konur eru líklegri til að hafa langvinnan háþrýsting (p<0,001) fyrir þungun, fá meðgönguháþrýsting (p=0,03), meðgöngueitrun (p=0,007), meðgöngusykursýki (p<0,001), einkenni frá stoðkerfi (p=0,04), að framkalla þurfi fæðingu (p=0,006) og að fæða með keisaraskurði (p<0,001), bæði bráða- (p=0,012) og valkeisaraskurði (p=0,008), samanborið við mæður í kjörþyngd og ofþyngd. Nýburar of feitra kvenna eru þyngri (p=0,004), með stærra höfuðummál (p<0,001) og eru oftar lagðir inn á nýburagjörgæslu (p=0,004) en börn mæðra í kjörþyngd og ofþyngd. Ályktun:Offita hefur óæskileg áhrif á heilsufar verðandi mæðra og barna þeirra. Áhrifin koma fram á meðgöngu, í fæðingu og hjá börnum þeirra. Mikilvægt er að konur á barneignaraldri fái upplýsingar um hvaða áhrif offita hefur á meðgöngu, fæðingu og nýbura.
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