3种孕期增重曲线特征及增重推荐范围探讨  

Characteristics of three pregnancy weight gain curves and recommendation of maternal weight gain

作　　者：蒋一方[1] 金焱[2] 林钟芳[1] 丁美芳[2] 周密[2] 

机构地区：[1]上海交通大学附属儿童医院,200040 [2]上海国际和平妇幼保健院

出　　处：《中国妇幼保健》2007年第31期4411-4415,共5页Maternal and Child Health Care of China

基　　金：上海市妇女儿童工作委员会基金资助

摘　　要：目的:分析孕前体质指数(BMI)正常母亲不同类型孕期增重曲线特征,探讨与巨大儿关系,并提出12～38周孕期增重的适宜、临界及干预推荐范围。方法:①收集上海市1990～2005年新生儿出生体重45392例。②收集上海市659例孕妇年龄、身高、孕前体重、孕期体重测量记录及其婴儿出生体重。对446例孕前BMI正常(18.2～22.6kg/m2)的母亲,按其婴儿出生体重分为A组(2.5～3.5kg)、B组(3.5～4.0kg)和C组(≥4.0kg)。③应用LMS软件,建立3组孕期累积增重百分位曲线,并根据累积增重的中位数计算孕期每周增重及每周增重速率。④据百分位研究,推导上海市孕前BMI正常母亲每周增重的推荐范围。⑤使用方差分析探讨出生体重与母亲相关因素。结果:①上海市巨大儿发生率自1999年的5.9%缓慢上升至2005年的6.6%,男婴发生率高于女婴。②孕前BMI正常的3组孕母的增重曲线呈现有规则的变化:3组孕期累积增重的中位数曲线呈平行上升,巨大儿组曲线在12周后一直高于A和B曲线。3组每周增重曲线均呈先上升后下降的钟形。巨大儿组开始每周增重较慢,后迅速上升,19周后高于曲线A和B。其峰值在24周达到(0.74kg/周),且高于曲线A和B。每周增重速率曲线C在13周时为9.8%,明显低于曲线A(15.2%)和B(18.2%),此后略有上升,至22周时3组曲线以相似速率持续下降(约10.3%)。③巨大儿与母亲身高、孕前体重、孕前BMI和孕期增重有关,与胎龄和母亲年龄无关。④孕前BMI正常的孕妇孕期增重(38周)的适宜范围、临界范围和干预范围分别为12.0～15.5kg、15.5～16.9kg和>16.9kg,并列出各推荐范围的在12～38周的每周推荐值。结论:①孕前BMI正常母亲巨大儿各类曲线的特征不同于正常体重婴儿。②研制了孕前BMI正常母亲12～38周孕期增重的适宜范围、临界范围和干预范围,首次在国内研制出孕期增重的每周推荐值。Objective： To develop a new recommendation for pregnancy weight gain, we analysis characteristics of different curve patterns of pregnancy Weight gain for Shanghai women with normal pre - pregnancy BMI and its relation to maerosomia. Methods：①Collect data of birth weight of 45 392 babies born during 1990 -2005. ②Colleet data of age, height and weight of 659 women before and during pregnancy and their children＇s birth weight. The 446 women with normal pre - pregnancy BMI （ 18. 2 - 22. 6 kg/m^2 ） are classified into 3 groups based on their babies sizes： A （2. 5 -3. 5 kg）, B （3. 5 -4. 0 kg）, and C group （ I≥4. 0 kg） ; ③ Construct percentiles of pregnancy accumulate weight gain for 3 groups by using LMS method. Calculate weekly weight gain and weight gain velocity based on the medium of accumulative weight gain; ④ Deduce the recommendation of weight gain range on each week of pregnancy for women with normal pre - pregnancy BMI; ⑤ Use analysis of variance to discuss the birth weights and associated factors of mothers. Results： ①Maerosomia incidence increases from 5. 9% in 1999 to 6. 6% in 2005 in Shanghai. The incidence is higher in boys than that in girls; ②The medium curves of pregnancy accumulate weight gain of 3 groups ascend parallel from 12th to 38th weeks, but the C curve is always higher than A and B curve. For weekly weight gain curves, all of 3 groups shapes like bell ： ascend first, then descend. The C curve is lower at first, then ascends steeply and over the levels of A and B curve at 19th week, finally reaches peak value at 24th week. For the velocity curve of weight gain, the C curve （9. 8% ） is lower than A （ 18. 2% ） and B curve （ 15. 2% ） at 13th week, then ascends slightly, and descends similarly with the A and B curve at 22th week （about 10. 3% ） ; ③ blaerosomia is associated with maternal height, pre - pregnancy weight and BMI, and pregnancy weight gain, but not associated with gestational age and maternal age; ④ The ideal, marginal

关 键 词：巨大儿 孕前BMI 孕期增重 推荐值 增重曲线类型 

分 类 号：R714[医药卫生—妇产科学]