妊娠晚期体重管理对超重初产妇母婴结局影响研究  

Effect of weight management on maternal and infant outcomes of overweight primiparas in late pregnancy

作　　者：金美媛[1] 彭美莲[1] 洪秋慧 熊智慧[1] 朱尧汝 JIN Mei-yuan;PENG Mei-lian;HONG Qiu-hui;XIONG Zhi-hui;ZHU Yao-ru(Obstetrics and Gynecology,Zhefiang Provincial Tong De Hospital,Hangzhou 310012,China)

机构地区：[1]浙江省立同德医院产科,浙江杭州310012

出　　处：《中国实用妇科与产科杂志》2018年第12期1401-1404,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：浙江省医药卫生科技计划项目(2012KYB042)

摘　　要：目的探讨妊娠晚期体重管理对超重初产妇母婴妊娠结局的干预效果。方法选择2014年1月至2017年12月在浙江省立同德医院建档、定期产检和分娩的6027例孕产妇,以2009年美国医学研究院(IOM)修订的孕前体重及孕期增重指南作为标准,分为孕前低体重(BMI<18.5)、正常体重(18.5≤BMI<25.0)、超重(25.0≤BMI<30.0)、肥胖(BMI≥30.0)。将孕前超重的220例妊娠晚期(28～42周)初产妇作为研究对象,分为对照组和管理组,每组110例。对照组给予常规产检,管理组在对照组基础上给予体重控制等干预措施,比较两组体重增长情况(妊娠晚期总增重及其速率),分析母婴妊娠结局。结果对照组和管理组妊娠晚期体重增长速率及脂代谢、妊娠期高血压疾病、剖宫产、产后出血、巨大儿、新生儿窒息发生率比较,差异均有统计学意义(P<0.05);两组低出生体重儿及早产儿发生率比较,差异无统计学意义(P>0.05)。结论孕前超重初产妇孕晚期经严格的体重管理能改善脂代谢,有效降低妊娠期合并症和产后并发症的发生率,减少新生儿出生不良结局,保证母婴安全。Objective To investigate the intervention effect of weight management on the pregnancy outcome of overweight primiparas in the third trimester of pregnancy(28-42 weeks).Methods Totally 220 overweight primiparas before pregnancy were chosen as the research subjects from 6027 pregnant women who had been documented,and given regular prenatal examination,and then had delivered in Zhejiang Provinical Tong De Hospital from January 2014 to December 2017.According to the guidelines for prenatal weight and weight gain revised by the American Academy of Medical Sciences(IOM)in 2009(low BMI:BMI<18.5,normal BMI:18.5 ≤BMI<25.0,high BMI:25.0≤BMI<30.0,and obesity:BMI≥30.0),they were randomly divided into control group(110 patients)and observation group(110 patients).The control group was given routine prenatal examination,and the observation group was given interventions such as weight control on the basis of the routine examination.Compare the weight gain of the two groups(total weight gain and its rate in the third trimester),and studied the maternal-infant pregnancy outcomes.Results There were significant differences in weight gain and growth rate,lipid metabolism,gestational hypertension,cesarean section,postpartum hemorrhage,macrosomia and neonatal asphyxia between the two groups(P<0.05).There was no significant difference in the incidence of low birth weight infants or premature infants(P>0.05).Conclusion Strict weight management can improve lipid metabolism,reduce the incidence of complications and postpartum complications effectively,decrease the adverse birth outcomes of newborns,and ensure maternal-infant safety in the overweight primiparas before pregnancy.

关 键 词：超重 孕晚期 初产妇 临床干预 母婴结局 

分 类 号：R715.3[医药卫生—妇产科学]