孕前BMI与胎次对妊娠期高血压疾病影响  

Effect of pre-pregnancy BMI and parity on hypertensive disorders among pregnant women

作　　者：朱若平[1] 郝加虎[1,2] 朱鹏[1,2] 陶瑞雪[3] 刘荃[3] 贾晓敏[1] 牛影[1] 陶芳标[1,2] 

机构地区：[1]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,安徽合肥230032 [2]安徽人口健康与优生省级实验室 [3]合肥市第一人民医院妇产科

出　　处：《中国公共卫生》2015年第3期272-275,共4页Chinese Journal of Public Health

基　　金：国家自然科学基金(81072310;30901203);国家科技支撑计划(2006BAI05A03)

摘　　要：目的探讨胎次与孕前BMI对妊娠期高血压疾病的影响。方法以2011年2月—2012年12月在安徽省合肥市第一人民医院进行孕产期检查并分娩的1 633名孕妇为研究对象,采用2检验和logistic回归模型分析胎次和孕前BMI与妊娠期高血压疾病的关系。结果孕妇孕前BMI均数为（20.20±2.418）kg/m2,消瘦367人（22.5%）,正常1 153人（70.6%）,超重或肥胖113人（6.9%）;第一胎936人（57.3%）,第二胎及以上697人（42.7%）;单因素logistic回归模型结果显示,孕前超重或肥胖的孕妇第一胎、二胎及以上发生妊娠期高血压疾病的风险均升高（OR=2.722,95%CI=1.074~6.900;OR=4.356,95%CI=1.865~10.171）;调整混杂因素孕妇实足年龄、文化程度、工作性质后的多因素logistic回归模型结果显示,胎次是孕前超重或肥胖孕妇患妊娠期高血压疾病的危险因素（第2胎及以上：OR=3.535,95%CI=1.472~8.491,P=0.005）。结论孕前超重及肥胖妇女妊娠胎次越多发生妊娠期高血压疾病的风险越高。Objective To explore whether adverse effects of pre-pregnancy body mass index（ BMI） on hypertension disorders in pregnancy are moderated by gravidity. Methods A total of 1 633 pregnant women who had antenatal care in their early pregnancy and delivered from February 2011 to December 2012 were selected as study subjects. The associations of parity and pre-pregnancy BMI with hypertension disorders in pregnancy were evaluated with Chi-square analysis and logistic regression. Results The average pre-pregnancy BMI for the pregnant women was 20. 20（ 2. 418 kg / m2）.Based on the pre-pregnancy BMI,367 women were classified as emaciation（ 22. 5%）,1 153 as normal（ 70. 6%）,and113 as overweight or obese（ 6. 9%）. Of the women,936（ 57. 3%） were nulliparous and 697（ 42. 7%） were multiparity.Univariate analysis showed that the risk of hypertension disorders among pre-pregnancy overweight or obese pregnant women increased with the odds ratio（ OR） of 2. 722（ 95% confidence interval[95% CI]= 1. 074- 6. 900,P = 0. 035） and4. 356（ 95% CI = 1. 865- 10. 171,P = 0. 001）. After adjusting for confounding factors such as pregnant chronological age,education level,and job category,multivariate analysis showed that parity was a risk factor of hypertension disorders in pregnancy for pre-pregnancy overweight or obese pregnant women（ for multiparity： OR = 3. 535,95% CI = 1. 472-8. 491; P = 0. 005）. Conclusion Pre-pregnancy overweight or obese pregnant women who had more parity are at a higher risk of hypertensive disorders in pregnancy.

关 键 词：胎次 孕前BMI 妊娠期高血压疾病 

分 类 号：R544.1[医药卫生—心血管疾病]