孕前BMI与妊娠结局及胎盘转运效率的关系  

Associations of maternal pre-pregnancy body mass index with pregnancy outcome and placental transport efficiency

作　　者：王晶晶 王鑫[1] 陈书强[1] 姜锋[1] 邸曼 王晓红[1] WANG Jing-jing;WANG Xin;CHEN Shu-qiang;JIANG Feng;DI Man;WANG Xiao-hong(Department of Gynecology and Obstetrics, Tangdu Hospital of the Fourth Military Medical University, Shaanxi Xi ＇ an 710038, China)

机构地区：[1]第四军医大学唐都医院妇产科,陕西西安710038

出　　处：《中国妇幼健康研究》2018年第6期702-705,共4页Chinese Journal of Woman and Child Health Research

基　　金：国家自然科学基金资助项目(编号:81671463);唐都医院科技创新基金资助项目(编号:2016JCYJ004)

摘　　要：目的探讨陕西西安地区育龄妇女孕前身体质量指数(BMI)与孕期增重(GWG)、妊娠结局及胎盘转运效率的关系。方法收集2017年1至4月在第四军医大学唐都医院产科分娩的产妇245例,记录其一般情况、孕期增重、妊娠结局、新生儿情况等进行统计分析。根据中国成人BMI分类推荐,分为低体重组(A组,BMI<18.5kg/m^2),正常体重组(B组,BMI 18.5~23.9kg/m^2)和超重组(C组,BMI≥24kg/m^2)。结果 (1)3组的孕期增重:与B组相比,A组孕期增重不足率显著升高、增重超标率显著降低(χ~2值分别为4.706、4.493,均P<0.05);C组孕期增重正常率显著降低,增重超标率显著升高(χ~2值分别为10.548、14.754,均P<0.01);(2)3组的妊娠结局:C组妊娠期并发症(妊娠期高血压、妊娠期糖尿病、胎膜早破、羊水过少)发生率均显著高于B组(χ~2值分别为12.854、3.943、5.818、4.322,均P<0.05);(3)比较3组新生儿情况,巨大儿比例及剖宫产率均有统计学差异(χ~2值分别为12.897、6.538,均P<0.05),新生儿性别比例并无统计学差异(χ~2=0.028,P>0.05),3组新生儿体重、胎盘重量及新生儿BMI均有统计学差异(F值分别为7.261、5.190、3.097,均P<0.05),新生儿身长及胎盘转运效率(P/F)并无统计学差异(F值分别为0.895、0.150,均P>0.05)。结论过高的孕前BMI是诱发妊娠期并发症及巨大儿的可能原因,合理控制孕前BMI及孕期增重,有利于获得良好的母婴结局。Objective To investigate the relationship between pre-pregnancy body mass index（BMI）and gestational weight gain（GWG）,pregnancy outcome and placental transport efficiency in childbearing-aged women living in Xi＇an.Methods Totally 245 pregnant women giving birth in obstetrics department in Tangdu Hospital of the Fourth Military Medical University from January to April 2017 were selected.Their general situation,GWG,pregnancy outcome and neonatal situation were recorded and analyzed.They were divided into underweight group（group A,BMI18.5 kg/m^2）,normal weight group（group B,18.5≤BMI≤23.9 kg/m^2）and overweight group（group C,BMI≥24 kg/m^2）according to Chinese adult BMI classification recommendations.Results For GWG in three groups,rate of insufficient GWG increased significantly while rate of excessive GWG decreased significantly in group A compared with that in group B（χ-2 value was 4.706 and 4.493,respectively,both P〈0.05）.Rate of normal GWG decreased significantly while rate of excessive GWG increased significantly in group C（χ-2 value was 10.548 and 14.754,respectively,both P〈0.01）.For pregnancy outcomes in three groups,occurrence rates of pregnancy complications（such as pregnancy induced hypertension,gestational diabetes mellitus,premature rupture of membranes,oligohydramnio）in group C were significantly higher than those in group B（χ-2 value was 12.854,3.943,5.818 and 4.322,respectively,all P〈0.05）.For situation of newborns in three groups,differences in incidence of fetal macrosomia and cesarean delivery rate were statistically significant（χ^2 value was12.897 and 6.538,respectively,both P〈0.05）,whereas the difference in sex ratio had no statistical significance（χ^2=0.028,P〈0.05）.There were statistically significant differences in neonatal weight,placenta weight and neonatal BMI among 3 groups（F value was 7.261,5.190 and 3.097,respectively,all P〈0.05）,whereas the differences in neonatal length and placental transport efficiency（P/F）among

关 键 词：孕前体重指数 孕期增重 妊娠结局 胎盘转运效率 

分 类 号：R714.1[医药卫生—妇产科学]