摘要
目的通过马氏试验(Mallampati test,MT)分级变化探讨孕前体质量指数(body mass index,BMI)与产妇分娩期困难气道风险的相关性。方法选择2020年10月至2021年4月于复旦大学附属妇产科医院分娩的354例足月初产妇,根据孕前BMI分为低BMI组、正常BMI组和高BMI组。分析产妇临产初期、分娩后(胎盘娩出后20 min~1 h)及分娩后48 h MT分级的变化。采用多因素logistic回归模型,分析分娩后MT分级增加的影响因素。结果354例产妇中,97例(27.4%)产妇MT分级在分娩后增加,MT分级3~4级的产妇由临产初期的39例(11.0%)增加到分娩后的77例(21.8%)。分娩后48 h MT分级3~4级的产妇下降到21例(5.9%)。多因素logistic回归分析结果显示,孕前低BMI(vs高BMI:OR=2.15,95%CI 1.02~4.53,P=0.045)和孕期打鼾史(OR=2.32,95%CI 1.38~3.90,P=0.001)是产妇MT分级升高的危险因素。结论产妇MT分级可在分娩后增加,孕前低BMI和孕期打鼾史是分娩后MT分级升高的危险因素。
Objective To explore the correlation between pre-pregnancy body mass index(BMI)and the risk of difficult airway during labor and delivery through grading changes of Mallampati test(MT).Methods A total of 354 primiparous women who delivered at Obstetrics and Gynecology Hospital of Fudan University from October 2020 to April 2021 were enrolled and categorized into low BMI,normal BMI,and high BMI groups based on pre-pregnancy BMI.Changes in MT grading were analyzed during early labor,postpartum(20 minutes to 1 hour after placental delivery),and 48 hours postpartum.A multifactor logistic regression model was used to analyze the factors increased MT grading postpartum.Results Among the 354 participants,97(27.4%)exhibited increased MT grading postpartum,with the proportion of women classified as MT grade 3-4 rising from 39(11.0%)during early labor to 77(21.8%)postpartum.By 48 hours postpartum,the number of women with MT grade 3-4 decreased to 21(5.9%).Multifactor logistic regression analysis showed that low pre-pregnancy BMI(vs high BMI:OR=2.15,95%CI 1.02-4.53,P=0.045)and snoring history during pregnancy(OR=2.32,95%CI 1.38-3.90,P=0.001)were independent risk factors for postpartum MT grading elevation.Conclusions MT grading might increase postpartum in parturients,with low pre-pregnancy BMI and prenatal snoring history identified as significant risk factors for elevated MT grading after delivery.
作者
陈去非
李雁楠
高华
尹惠芬
CHEN Qufei;LI Yannan;GAO Hua;YIN Huifen(Department of Anesthesia,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200001,China;Department of Obstetrics,Obstetrics and Gynecology Hospital of Fudan University,Shanghai 200001,China)
出处
《中国临床医学》
2025年第3期486-492,共7页
Chinese Journal of Clinical Medicine
关键词
马氏试验
体质量指数
产妇
困难气道
分娩
Mallampati test grading
body mass index
parturient
difficult airway
labor and delivery
