PDF(Pubmed)
Abstract：
OBJECTIVE: This study aimed to determine whether excessive maternal weight gain during pregnancy was associated with a higher risk of prolonged labor.
METHODS: We analyzed the data regarding maternal weight gain during pregnancy for the participants of Japan Environment and Children\'s Study (JECS), which is an ongoing nationwide prospective birth cohort study in Japan. After excluding participants with multiple pregnancies, with deliveries before 37 or beyond 42 weeks of gestation, or who had undergone cesarean section, 71,154 (nulliparous, n = 28,442) Japanese women were included. Prolonged labor was defined by a cutoff ranking at the 95th percentile and consequently defined as labor duration exceeding 12.7 h in multiparous women and exceeding 23.2 h in nulliparous women. These classifications were made according to labor curves established by the Japanese Society of Obstetrics and Gynecology Perinatal Committee developed in June 2021. Considering that no studies have conducted an investigation based on this new guideline, we analyzed the association between excessive maternal weight gain during pregnancy and prolonged labor by parity.
RESULTS: The overall incidence of prolonged labor was 10.2% (2,907/28,442) in nulliparous women and 6.1% (2,597/42,712) in multiparous women. Multivariable analysis indicated that excessive maternal weight gain was significantly associated with prolonged labor in nulliparous (adjusted odds ratio, 1.21; 95% confidence interval, 1.10-1.32) and multiparous women (adjusted odds ratio, 1.15; 95% confidence interval, 1.05-1.27). Kaplan-Meier survival analysis showed that as labor progressed, the percentage of women who had not yet delivered was higher among those with excessive maternal weight gain than among those with normal maternal weight gain in both the nulliparous (median labor duration 12.9 h vs 12.2 h, p<0.001) and multiparous (median labor duration 6.2 h vs 5.8 h, p<0.001) groups.
CONCLUSIONS: Excessive maternal weight gain was significantly associated with prolonged labor in Japanese women.
METHODS: We analyzed the data regarding maternal weight gain during pregnancy for the participants of Japan Environment and Children\'s Study (JECS), which is an ongoing nationwide prospective birth cohort study in Japan. After excluding participants with multiple pregnancies, with deliveries before 37 or beyond 42 weeks of gestation, or who had undergone cesarean section, 71,154 (nulliparous, n = 28,442) Japanese women were included. Prolonged labor was defined by a cutoff ranking at the 95th percentile and consequently defined as labor duration exceeding 12.7 h in multiparous women and exceeding 23.2 h in nulliparous women. These classifications were made according to labor curves established by the Japanese Society of Obstetrics and Gynecology Perinatal Committee developed in June 2021. Considering that no studies have conducted an investigation based on this new guideline, we analyzed the association between excessive maternal weight gain during pregnancy and prolonged labor by parity.
RESULTS: The overall incidence of prolonged labor was 10.2% (2,907/28,442) in nulliparous women and 6.1% (2,597/42,712) in multiparous women. Multivariable analysis indicated that excessive maternal weight gain was significantly associated with prolonged labor in nulliparous (adjusted odds ratio, 1.21; 95% confidence interval, 1.10-1.32) and multiparous women (adjusted odds ratio, 1.15; 95% confidence interval, 1.05-1.27). Kaplan-Meier survival analysis showed that as labor progressed, the percentage of women who had not yet delivered was higher among those with excessive maternal weight gain than among those with normal maternal weight gain in both the nulliparous (median labor duration 12.9 h vs 12.2 h, p<0.001) and multiparous (median labor duration 6.2 h vs 5.8 h, p<0.001) groups.
CONCLUSIONS: Excessive maternal weight gain was significantly associated with prolonged labor in Japanese women.
摘要：
目的：本研究旨在确定妊娠期间孕妇体重过度增加是否与延长分娩的风险有关。
方法：我们分析了日本环境与儿童研究（JECS）参与者怀孕期间母亲体重增加的数据，这是日本正在进行的全国性前瞻性出生队列研究。排除多胎妊娠的参与者后，在妊娠37周或超过42周之前分娩，或者是剖腹产,71,154（未产，n=28,442）包括日本女性。延长的劳动由第95百分位数的截止排名定义，因此定义为多产妇女的劳动持续时间超过12.7h，未产妇女的劳动持续时间超过23.2h。这些分类是根据日本妇产科学会围产期委员会于2021年6月制定的劳动曲线进行的。考虑到没有研究根据这个新指南进行调查，我们分析了孕妇孕期体重过度增加与产程延长之间的关系.
结果：在未分娩妇女中，长期分娩的总发生率为10.2％（2,907/28,442），在经产妇女中为6.1％（2,597/42,712）。多变量分析表明，孕妇体重过度增加与未分娩分娩时间延长显着相关（调整后的优势比，1.21；95%置信区间，1.10-1.32)和多胎女性(调整后的赔率比，1.15；95%置信区间，1.05-1.27)。Kaplan-Meier生存分析显示，随着分娩的进展，在两个未产者中，孕妇体重增加过多的妇女中尚未分娩的妇女的百分比高于孕妇体重增加正常的妇女中（中位分娩时间12.9hvs12.2h，p<0.001）和经产（中位产程6.2hvs5.8h，p<0.001)组。
结论：在日本妇女中，母亲体重过度增加与分娩时间延长显著相关。
方法：我们分析了日本环境与儿童研究（JECS）参与者怀孕期间母亲体重增加的数据，这是日本正在进行的全国性前瞻性出生队列研究。排除多胎妊娠的参与者后，在妊娠37周或超过42周之前分娩，或者是剖腹产,71,154（未产，n=28,442）包括日本女性。延长的劳动由第95百分位数的截止排名定义，因此定义为多产妇女的劳动持续时间超过12.7h，未产妇女的劳动持续时间超过23.2h。这些分类是根据日本妇产科学会围产期委员会于2021年6月制定的劳动曲线进行的。考虑到没有研究根据这个新指南进行调查，我们分析了孕妇孕期体重过度增加与产程延长之间的关系.
结果：在未分娩妇女中，长期分娩的总发生率为10.2％（2,907/28,442），在经产妇女中为6.1％（2,597/42,712）。多变量分析表明，孕妇体重过度增加与未分娩分娩时间延长显着相关（调整后的优势比，1.21；95%置信区间，1.10-1.32)和多胎女性(调整后的赔率比，1.15；95%置信区间，1.05-1.27)。Kaplan-Meier生存分析显示，随着分娩的进展，在两个未产者中，孕妇体重增加过多的妇女中尚未分娩的妇女的百分比高于孕妇体重增加正常的妇女中（中位分娩时间12.9hvs12.2h，p<0.001）和经产（中位产程6.2hvs5.8h，p<0.001)组。
结论：在日本妇女中，母亲体重过度增加与分娩时间延长显著相关。
