体重指数与分娩住院中残留胎盘之间的关联：2016-2020年全国住院样本分析
Associations between body mass index and retained placenta in delivery hospitalizations: Analysis of the Nationwide Inpatient Sample, 2016-2020.
摘要(中文译文)
胎盘滞留（RP）是一种产科并发症，与产后出血、脓毒症及孕产妇发病率相关。尽管孕产妇体重指数（BMI）影响妊娠结局，但其与胎盘滞留的关联尚不明确。本研究旨在利用具有全国代表性的住院患者数据集，探讨BMI、人口学及临床因素与胎盘滞留之间的关联。本回顾性研究分析了2016至2020年美国全国住院患者样本中年龄≥18岁、因分娩住院的女性数据。胎盘滞留通过ICD-10编码进行识别。纳入的女性根据BMI分为非肥胖（<30.0 kg/m²）、肥胖（30.0-39.9 kg/m²）和重度肥胖（≥40.0 kg/m²）。采用加权logistic回归分析确定研究变量与胎盘滞留发生之间的关联。在3 590 940例分娩住院中，28 935名女性（0.8%）发生胎盘滞留。多因素分析确定高龄产妇（调整比值比[aOR]=1.046，95% CI：1.044-1.049）、肥胖（aOR=1.18）、重度肥胖（aOR=1.25）、多囊卵巢综合征（PCOS）（aOR=1.33）、子宫内膜异位症（aOR=2.28）、吸烟（aOR=1.33）、多胎妊娠（aOR=2.37）、子宫手术（aOR=2.04）、流产（aOR=1.43）及不孕症（aOR=1.87）为胎盘滞留的独立危险因素。剖宫产分娩（相较于阴道分娩）与胎盘滞留风险显著降低相关（aOR=0.14）。亚组分析证实，在年龄、早产及未足月胎膜早产（PPROM）各亚组中危险因素保持一致，多胎妊娠、子宫内膜异位症、多囊卵巢综合征、肥胖及吸烟仍为显著预测因素。肥胖是胎盘滞留的独立危险因素，重度肥胖风险最高。研究结果强调需要对高危人群实施以患者为中心的产科管理。
Abstract
Retained placenta (RP) is an obstetric complication associated with postpartum hemorrhage, sepsis, and maternal morbidity. While maternal body mass index (BMI) influences pregnancy outcomes, its associations with RP are unclear. We aimed to examine associations between BMI, demographic and clinical factors, and RP using a nationally representative inpatient dataset. This retrospective study analyzed data of women aged ≥18 years with delivery hospitalizations from the US Nationwide Inpatient Sample 2016-2020. RP was identified using the ICD-10 codes. Included women were classified on the basis of BMI as non-obese (<30.0 kg/m), obese (30.0-39.9 kg/m), and morbidly obese (≥40.0 kg/m). Weighted logistic regression analysis determined associations between study variables and RP occurrence. Among 3 590 940 delivery hospitalizations, 28 935 women (0.8%) had RP. Multivariable analysis identified advanced maternal age (adjusted odds ratio [aOR] = 1.046, 95% CI: 1.044-1.049), obesity (aOR = 1.18), morbid obesity (aOR = 1.25), polycystic ovary syndrome (PCOS) (aOR = 1.33), endometriosis (aOR = 2.28), smoking (aOR = 1.33), multiple pregnancy (aOR = 2.37), uterine surgery (aOR = 2.04), abortion (aOR = 1.43), and infertility (aOR = 1.87) as independent risk factors for RP. Cesarean delivery (vs. vaginal delivery) was significantly associated with a lower risk of RP (aOR = 0.14). Subgroup analyses confirmed consistent risk factors across age, prematurity, and PPROM, with multiple pregnancy, endometriosis, PCOS, obesity, and smoking remaining significant predictors. Obesity is an independent risk factor for RP, and morbid obesity confers the highest risk. Study findings emphasize the need for patient-focused obstetric management in high-risk populations.
如何引用
AMA
Jui-Der Liou, Cheng-Wei Yu, Wen-Chi Hsieh, Tsung-Yi Tzang, Cheng-Yu Ho. Associations between body mass index and retained placenta in delivery hospitalizations: Analysis of the Nationwide Inpatient Sample, 2016-2020.. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2026; doi:10.1002/ijgo.71214.
APA
Jui-Der Liou, Cheng-Wei Yu, Wen-Chi Hsieh, Tsung-Yi Tzang, Cheng-Yu Ho (2026). Associations between body mass index and retained placenta in delivery hospitalizations: Analysis of the Nationwide Inpatient Sample, 2016-2020.. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. https://doi.org/10.1002/ijgo.71214
GB/T 7714
Jui-Der Liou, Cheng-Wei Yu, Wen-Chi Hsieh, Tsung-Yi Tzang, Cheng-Yu Ho. Associations between body mass index and retained placenta in delivery hospitalizations: Analysis of the Nationwide Inpatient Sample, 2016-2020.[J]. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026 doi:10.1002/ijgo.71214.
在 PubMed增强版 阅读全文
翻译全文 · AI 文献问答 · PDF 原文下载 · 引用导出