妊娠前体重指数与妊娠期增重和母婴并发症的关系及其影响因素  

Influence factors of body mass index before pregnancy and the relationship with gestational weight gain,maternal and infants complications

作　　者：许晓英[1] 周敏[1] 何晓春[1] 刘青[1] 仇杰[1] 

机构地区：[1]甘肃省妇幼保健院围产中心,兰州730050

出　　处：《中华围产医学杂志》2015年第5期352-358,共7页Chinese Journal of Perinatal Medicine

摘　　要：目的 探讨甘肃地区妇女妊娠前超重与肥胖的发生情况,分析其相关因素,并研究妊娠前体重指数（body mass index,BMI）与妊娠期增重和母婴并发症的关系. 方法 整群抽取2010年2月至2011年12月期间在甘肃省妇幼保健院分娩的孕妇进行回顾性问卷调查.采用世界卫生组织推荐的亚洲人群BMI分类标准分析研究对象超重及肥胖的发生情况.分析超重及肥胖的相关因素,以及妊娠前BMI与妊娠期体重增长和发生母婴并发症的关系.采用方差分析、x2检验、等级相关分析、单因素和多元Logistics回归分析进行统计学处理. 结果 共6 400例产妇纳入本研究.6 400例孕妇BMI为13.3～38.1,平均为20.6±2.7.根据世界卫生组织推荐的亚洲人群BMI分类标准,6 400例孕妇中,超重636例（9.9％）,肥胖416例（6.5％）.BMI与年龄呈正相关,体重过低组、体重正常组、超重组和肥胖组孕妇平均年龄逐渐增大[分别为（27.8±3.8）、（29.1±4.3）、（30.3±4.7）和（30.6±4.6）岁],差异有统计学意义（F=77.490,P＜ 0.01）.随年龄增加,BMI逐渐增高（r=0.18,P＜0.01）;非初产妇BMI高于初产妇（分别为21.2±2.6和20.4±2.6）,差异有统计学意义（t=-9.630,P＜ 0.01）;BMI与教育程度及经济收入水平呈负相关（r=-0.06,P＜0.01;r=-0.04,P=0.036）.随BMI增加,4组妊娠13周内增重、妊娠期总增重逐渐减少（F值分别为8.892和21.700,P值均＜0.01）.超重组新生儿出生体重最大,依次高于肥胖组、体重正常组和体重过低组,4组差异有统计学意义（F=11.261,P＜0.01）.随着BMI升高,4组中单胎孕妇妊娠期高血压疾病、妊娠期糖尿病、产后出血、新生儿肺透明膜病和新生儿低血糖发生率逐渐升高（x2值分别为85.758、58.913、13.501、6.563和9.579,P值均＜0.05）,剖宫产率和巨大儿、出生缺陷发生率逐渐升高（x2值分别为125.442、62.963和9.087,P值均＜0.05）.超重组脐带异常发生率依次高于体Objective To explore the prevalence and the relative factors of the overweight and the obese in a population of Gansu Province pre-pregnancy women.and the effects of pre-pregnancy maternal body mass index （BMI） on gestational weight gain and pregnant outcome.Methods We conducted a populationbased birth cohort study in Gansu Province Maternity and Child Health Care Hospital from February,2010 to December,2011.Single live term birth women who have complete anthropometry were enrolled this study.They were categorized into four BMI groups according to World Health Organization＇s BMI recommendations for Asian populations.We explored the prevalence and the relative factors of the overweight and the obese,and the effects of pre-pregnancy maternal body mass index on gestational weight gain and birth outcomes by Chi-square test,analysis of variance.Results A total of 6 400 cases included in this study.The BMI range is from 13.3 to 38.1,the average BMI is （20.6 ±2.7）.Among 6 400 cases,636 cases（9.9%） and 416 cases （6.5%） were overweight and obese.The average age （unit：years） is increase gradually in low weight group （27.8±3.8）,normal group （29.1 ±4.3）,overweight group （30.3 ±4.7） and obese group （30.6±4.6）,the difference was statistically significant （F=77.490,P〈0.01）.The result prompt that the median BMI increased with the increasing of maternal age （r=0.18,P〈0.01）.The BMI of multiparous women （21.22 ±2.63） is higher than nulliparous women （20.43 ± 2.64）,the difference was statistically significant （t=-9.630,P〈0.01）.The BMI has negatively correlated with education level and economic income level （r=-0.06,P〈0.01; r=-0.04,P=0.036）.With the increase of BMI,the weight gain of early （13 weeks） pregnancy （F=8.892,P〈 0.01） and the total weight gain during whole pregnancy （F=21.700,P〈 0.01） gradually reduced in four groups.The neonatal birth weight in overweight group is largest,in turn higher than obesity group,normal group and low wei

关 键 词：人体质量指数 体重增长 肥胖症 妊娠并发症 水电解质失调 婴儿 新生 

分 类 号：R714.7[医药卫生—妇产科学]