妊娠前BMI及妊娠期周增重对妊娠结局的影响  

Influence of body mass index before pregnancy and weekly gestational weight gain on pregnancy outcomes

作　　者：柳露[1] 洪忠新[1] 王佳[1] 丁冰杰[1] 毕研霞[1] 

机构地区：[1]首都医科大学附属北京友谊医院,北京100050

出　　处：《中国妇幼健康研究》2015年第6期1139-1142,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的分析妊娠前体质量指数(BMI)及妊娠期周增重对孕产妇围生结局和新生儿出生结局的影响。方法收集2014年1至9月在首都医科大学附属北京友谊医院妇产科产检并住院分娩的2 124例单活胎初产妇的产前检查记录和住院分娩病历资料,依据妊娠前BMI分为4组:低体质量组(BMI<18.5kg/m^2)、正常组(18.5kg/m^2≤BMI<24.0kg/m^2)、超重组(24kg/m^2≤BMI<28.0kg/m2)和肥胖组(BMI≥28.0kg/m2);依据妊娠期周增重四分位数间距分为4组:<0.31kg/w组,0.31~<0.39kg/w组,0.39~<0.46kg/w组,≥0.46kg/w组,分析妊娠前BMI及妊娠期周增重对妊娠结局的影响。结果相对于正常组,肥胖组孕产妇剖宫产、产后出血、早产、未足月胎膜早破(PPROM)、妊娠期糖尿病(GDM)、妊娠期高血压疾病和子痫前期的发生率均明显增加(x^2值分别为22.34,10.58,6.83,5.73,33.79,38.86,10.65,P<0.05或P<0.01)。相对于妊娠期增重幅度<0.31kg/w组,≥0.46kg/w组孕产妇剖宫产和巨大儿的发生率明显增加(x^2值分别为17.62,45.51,P均<0.01),而<0.31kg/w组足月低体质量儿发生率高于其他3组(x^2=9.42,P<0.01)。结论妊娠前肥胖和妊娠期周增重幅度过大或过小均可对孕妇和胎儿产生不利的影响,合理控制妊娠前体质量和妊娠期增重可改善妊娠结局。Objective To analyze the influence of body mass index （BMI） before pregnancy and median weekly weight gain during pregnancy on perinatal maternal and neonatal outcomes. Methods Data of 2 124 nulliparous women were selected from January to September in 2014. They took prenatal examination and delivered single live birth at Beijing Friendship Hospital Affiliated to Capital Medical University. BMI before pregnancy was categorized into four groups ： underweight group （ BMI 〈 18.5 kg/m2 ） , normal weight group （ 18.5 kg/m2 ≤BMI 〈 24. Okg/m2 ）, overweight group （24 kg/m2 ≤ BMI 〈 28.0 kg/m2 ）, and obesity group （ BMI≥28.0 kg/m2 ）. Weekly gestational weight gain was categorized to four groups according to quartile distribution （ 〈 0.31 kg/w, 0.31 -0.39 kg/w, 0.39 - 0.46kg/w and I〉0.46kg/w）. Results Compared with the normal weight group, the incidence of cesarean section, postpartum hemorrhage, preterm delivery, preterm premature rupture of membranes （ PPROM）, gestational diabetes mellitus （ GDM）, gestational hypertension and preeclampsia was significantly higher in obesity group （X2 value was 22.34, 10.58, 6.83, 5.73,33.79, 38.86 and 10.65, respectively, P 〈 0.05 or P 〈 0.01 ）. The incidence of cesarean section and fetal macrosomia was higher in the group with gestational weight gain of 0.46 kg per week or greater than in the group with gestational weight gain less than 0.31kg per week （X2 value was 17.62 and 45.51, respectively, both P 〈 0.01 ） , while the incidence of term low birth weight was highest in women with gestational weight gain less than 0.31 kg per week （X2 = 9.42, P 〈 0.01 ）. Conclusion High BMI before pregnancy, excessive weight gain and too little weight gain per week during pregnancy have adverse influence on pregnant women and fetus. Rational control of BMI before pregnancy and weight gain during pregnancy can improve pregnancy outcomes.

关 键 词：孕前体质量指数 肥胖 孕期平均周增重 妊娠结局 

分 类 号：R714[医药卫生—妇产科学]