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Índice de masa corporal pregestacional y el riesgo de eventos adversos maternos / Pregestational body mass index and risk of maternal adverse events

Jaime Jesús Durán-Nah, Alexander Porter-Magaña, Eva Navarro-Cabrera



Introducción: En la mujer en edad reproductiva, el sobrepeso y la obesidad pregestacional pueden ser adversos a los resultados de la gestación, tanto para la madre como para el producto.

Objetivo: Investigar la asociación entre el índice de masa corporal pregestacional (IMCP) y los eventos adversos maternos (EAM) durante el nacimiento del producto, en gestantes atendidas en un cuatrimestre de 2014, en un hospital público de Mérida, Yucatán, México.

Material y métodos: Se incluyeron 427 gestantes y se identificaron las que no tuvieron ningún EAM (n = 137), cuyos datos demográficos y clínicos, incluido el IMCP, fueron comparados con los del grupo que tuvo alguno (n = 290). Se obtuvieron razones de momios (RM) e intervalos de confianza del 95% (IC 95%) con un modelo de regresión logística binario (MRL).

Resultados: El 33% de la muestra tenía IMCP normal, el 30% tenía sobrepeso y el 37% presentaba obesidad pregestacional. Fue la operación cesárea urgente el EAM más frecuente (58.8%). El MRL identificó como significativamente asociados a los EAM la escolaridad secundaria (RM: 0.56; IC 95%: 0.34-0.94), ser primigesta (RM: 6.88; IC 95%: 3.37-12.58), ser secundigesta (RM: 5.57; IC 95%: 3.04-10.24), el número de visitas prenatales (≥ 5, RM: 3.49; IC 95%: 1.54-7.91) y el IMCP (sobrepeso, RM: 0.41; IC 95%: 0.23-0.72).

Conclusiones: Tener sobrepeso pregestacional redujo el riesgo de EAM hasta un 59%, la educación secundaria lo redujo un 44%, ser primigesta lo incrementó más de seis veces, ser secundigesta lo incrementó más de cinco veces y tener ≥ 5 visitas prenatales paradójicamente lo incrementó más de tres veces.



Background: In women of reproductive age, pregestational overweight and/or obesity could result in negative outcomes for both, mother and child.

Objective: To investigate the association between pregestational body mass index (PBMI) and maternal adverse outcomes (MAO) during childbirth, in women assisted during 2014, in a public hospital in Mérida, Yucatán, Mexico.

Material and methods: 427 pregnant women assisted during childbirth were consecutively included, identifying among them those who did not have any MAO (n  =  137), whose demographic and clinical data, including PBMI, were compared with those who did have at least one MAO (n = 290). Odds ratios (OR) and 95% confidence intervals (95%  CI) were obtained using a binary logistic regression model (LRM).

Results: 33% had normal PBMI, and 37% had obesity. Urgent cesarean section was the most frequent MAO (58.8%). According to the LRM, schooling (secondary school level, OR: 0.56; 95%  CI: 0.34-0.94), primigravidae (OR: 6.88; 95% CI: 3.37-12.58), and secondigravidae women (OR: 5.57; 95% CI: 3.04-10.24), the number of prenatal visits (≥ 5, OR: 3.49; 95%  CI: 1.54-7.91), and PBMI (overweight, OR: 0.41: 95%  CI: 0.23-0.72) were identified as clinically and statistically significant. 

Conclusions: Women with overweight were at low risk for MAO, while schooling (secondary school level) reduced risk by 44%, being a primigravidae or a secondigravidae increased risk more than 6 and 5 times, respectively. Paradoxically, prenatal visits (≥ 5 medical visits) increased risk more than 3 times.


Palabras clave

Índice de Masa Corporal; Factores de Riesgo; Obesidad Materna; Complicaciones del Embarazo; Evento Materno Adverso / Body Mass Index; Risk Factors; Obesity, Maternal; Pregnancy Complications; Adverse Maternal Event

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