孕前体质指数、孕期增重与新生儿出生体重和分娩方式的关系  

The relationship between pre-pregnant BMI,gestational weight gain and birth weight,delivery mode

作　　者：黄婕[1] 陆青贵[1] 欧阳静仪[1] 杨波[1] 楚心唯[1] 毛丽梅[1] 

机构地区：[1]南方医科大学公共卫生与热带医学学院营养与食品卫生学系,广东广州510515

出　　处：《中国妇幼保健》2013年第8期1235-1238,共4页Maternal and Child Health Care of China

基　　金："十一五"国家科技支撑计划〔2008BAI58B07〕

摘　　要：目的:探讨孕妇孕前体质指数(BMI)及孕期增重对新生儿出生体重和分娩方式的影响。方法:选取474名身体健康的孕晚期妇女作为调查对象,于分娩前后对孕妇及新生儿进行追踪调查,获得有效问卷442份。按孕前BMI及孕期增重分组进行整理分析。结果:调查对象孕期平均增重(15.80±4.60)kg,孕前超重及肥胖者孕期增重低于孕前低体重者(F=3.87,P<0.01)。新生儿平均出生体重(3 240.30±377.60)g,其中低出生体重儿10例(2.26%),巨大儿16例(3.62%)。剖宫产者占48.20%。Logistic回归分析显示,妇女孕前超重及肥胖是分娩巨大儿及剖宫产的危险因素;孕期增重>21.00 kg是分娩巨大儿的危险因素;增重>18.00 kg是剖宫产发生的危险因素。结论:孕前体质指数和孕期增重是巨大儿和剖宫产的重要影响因素,保持适宜的孕前体重及孕期合理增重对于改善出生结局有着积极的意义。Objective： To study the influence of maternal pre -pregnant BMI and gestational weight gain on neonatal birth weight and delivery mode. Methods： A total of 474 healthy pregnant women during the third trimester were selected as the participants. The respondents and their neonates were followed from pregnancy until delivery. All 442 valid samples were classified and analyzed according to pre - pregnant BMI and gestational weight gain. Results： The average gestational weight gain of subjects was （ 15.8 ± 4. 6） kg. The gestational weight gain of pre - pregnant overweight and obese group （ 13.5 ± 5.0 ） kg was significantly lower than low weight group （ 15.8 ＋ 4. 6） kg （ F = 3.87, P 〈 0. 01 ） . The average neonatal birth weight was （ 3 240. 3 ± 377.6） g, and the rate of low birth weight and macrosomias accounted was 2.26% and 3.62% respectively. Among all the subjects, cesarean section took up 48.2%. Logistic regression analysis showed that maternal overweight and obesity before pregnancy were risk factor for the incidence of maerosomia and cesarean section. Excess gestational weight gain of more than 21.0 kg was a risk factor of delivering fetal macrosomia, while a gestational weight gain of more than 18. Okg was a risk factor for the occurrence of cesarean section. Conclusion ： Pre - pregnant BMI and gestational weight gain are the important factors for birth Fetal macrosomia and delivery mode. It＇s very beneficial to keep weight before conception and balance weight gain during pregnancy.

关 键 词：孕前体质指数 孕期增重 巨大儿 剖宫产 

分 类 号：R715.3[医药卫生—妇产科学]