孕妇孕期适宜体质量增加范围的探讨及其与新生儿出生体质量的关系  

Gestational weight gain and its relationship with the birthweight of offspring

作　　者：王文鹏[1] 陈芳芳[1] 米杰[1] 滕越[2] 赵娟[3] 武明辉[4] 张雪[4] 张娣[4] 王军华[4] 滕红红[3] 

机构地区：[1]首都儿科研究所流行病学研究室,北京100020 [2]北京市海淀区妇幼保健院营养门诊 [3]首都医科大学附属北京妇产医院院办公室 [4]首都医科大学附属北京妇产医院群体保健信息科

出　　处：《中华妇产科杂志》2013年第5期321-325,共5页Chinese Journal of Obstetrics and Gynecology

基　　金：“十一五”国家科技支撑计划（2009BA180803）;首都医学发展基金（2011-管-15）

摘　　要：目的探讨健康足月孕妇孕期适宜体质量增加范围及其与新生儿出生体质量的关系。方法选择2010年1—12月在首都医科大学附属北京妇产医院和北京市海淀区妇幼保健院分娩的健康足月单胎孕妇16460例，将孕妇的年龄、身高、孕前体质指数（BMI）、历次产检体质量、分娩孕周与方式、新生儿卅生体质量等指标录人统一的病例回顾调查数据库，采用回顾性分析的方法对数据进行分析。以孕前BMI〈18．5kg／m^2定义为孕前低体质量组，孕前BMI为18．5～〈24．0k∥m。定义为孕前正常体质量组；孕前BMII〉24kg／m。为孕前超重组。新生儿出生体质量〈2500g为低出生体质量儿，2500～〈4000g为正常出生体质量儿，其中2900～3499g为最适宜出生体质量儿，≥4000g为巨大儿。结果（1）3组孕妇孕期体质量增加范围及新生儿卅生体质量：16460例孕妇孕期平均体质量增加范围（17．1±4．9）k，新生儿平均出生体质量为（3406±400）g，其中低出生体质量儿发生率为0．92％（152／16460），巨大儿发生率为7．55％（1242／16460）。孕前低体质量组（3089例）、正常体质量组（11478例）、超重组（1893例）孕妇的孕期体质量增加范围[分别为（17．4±4．6）、（17．3±4．8）、（15．6±5．3）k]与新生儿出生体质量均呈正相关关系（r分别为0．276、0．256和0．170，P均〈0．01）。3组孕妇孕期体质量增加范围、新生儿出生体质量分别比较，差异均有统计学意义（P均〈0．01）；巨大儿发生率3组间分别比较，差异均有统计学意义（P均〈0．01）。（2）百分位法分析3组孕妇孕期适宜的体质量增加范围：3组出生适宜体质量新生儿共8449例，孕前低体质量组、正常体质量组及超重组孕妇孕期体质量增加范围分别为14．0～19．5kg、13．5～19．5kg及11．0～18．0kg，平均增加16．0kg最为适宜。（3）孕期体质量�Objective To explore the appropriate weight gain during pregnancy and its relationship with the birthweight of offspring. Methods A total of 16 460 healthy pregnant women who delivered in Beijing Obstetrics and Gynecology Hospital and Haidian Maternity and Child Health Care Hospital in 2010 were recruited. All are singleton pregnancies. Conditions of bahies and mothers were recorded, including maternal age, height, prepregnant weight, pregnant weight, gestational weeks on delivery, delivery mode and newborn birthweight. All the pregnant women were divided into underweight, normal weight and overweight group according to their prepregnant body mass index and the criteria of overweight and obesity for Chinese adults. Birthweight between 2500 g and 4000 g was defined as normal birthweight, and 2900 g to 3499 g was defined as appropriate birthweight. Logistic regression model and receiver operating characteristic （ROC） curve analysis were used to explore the recommended gestational weight gain （GWG）. Results （ 1 ） The average GWG of the 16 460 women was （ 17.1 ±4.9） kg, and the average birthweight of the babies was （3406 ± 400） g. Prevalence of low birthweight and maerosomia was 0. 92% （152/16 460 ） and 7.55% （1 242/16 460） , respectively. GWG of underweight （ n = 3089） , normal weight （ n = 11 478 ） and overweight group （n = 1893） was （17.4 ± 4.6） kg, （17.3 ± 4.8） kg and （15.6 ± 5.3） kg, respectively. And GWG was positively related with the birthweight of offspring （P 〈 0. 01 ）. The differences of GWG, neonatal birthweight and macrosomia prevalenee among the three groups are statistieally significant （P 〈 0. 01 ）. （2） There are 8449 appropriate birthweight babies in the three groups. For their mothers in the underweight, normal weight and overweight group, the recommended range of GWG were 14.0 - 19.5 kg, 13.5 - 19. 5 kg and 11.0 - 18.0 kg, respectively. The recommended GWG for all women was 16.0 kg. （3） According to the recommended GWG, lo

关 键 词：妊娠 体重增长 婴儿 新生 出生体重 

分 类 号：R7[医药卫生—临床医学]