孕前体重指数及孕期增重对围生结局的影响  

Effect of pre-pregnancy body mass index and gestational weight gain on perinatal outcomes

作　　者：邢萌萌[1] 卫国[1] 王志隆[1] 任路忠[1] XING Meng-meng;WEI Guo;WANG Zhi-long;REN Lu-zhong(Ministry of Child Health,Shenzhen Long gang District Maternal and Child Health Care Hospital,Shenzhen,Guangdong 518172,China)

机构地区：[1]深圳市龙岗区妇幼保健院儿童保健部,广东深圳518172

出　　处：《中国儿童保健杂志》2020年第4期389-394,共6页Chinese Journal of Child Health Care

基　　金：深圳市龙岗区科技计划项目(LGKCYLWS2018000217)。

摘　　要：目的分析孕前体重指数(BMI)及孕期体重增长对围生结局的影响,为孕期保健、孕前和孕期体重管理提供依据。方法采用历史性队列研究方法,将深圳市龙岗区2014-2017年26家助产医院95849例单胎足月产妇按孕前BMI及孕期增重情况分组,观察各组围生结局。结果95849例孕妇平均孕前BMI为(20.49±2.83)kg/m2,平均孕期增重(14.49±5.89)kg。相比孕前正常BMI和孕期增重适宜的孕妇,孕前消瘦(BMI<18.5kg/m2)和孕期增重不足是低出生体重儿发生的危险因素,OR值(95%CI)分别为1.80(1.61~2.00)、1.83(1.63~2.05);孕前超重(BMI≥24 kg/m2)是妊娠期糖尿病(GDM)、妊娠期高血压、子痫前期/子痫、巨大儿、剖宫产、出生窒息发生的危险因素,OR值(95%CI)分别为1.84(1.68~2.02)、2.40(1.90~3.04)、3.07(2.39~3.96)、2.70(2.49~2.92)、1.89(1.81~1.97)及1.33(1.05~1.67);孕期增重过度是巨大儿、剖宫产、妊娠期高血压、子痫前期/子痫、胎膜早破、产后出血发生的危险因素,OR值(95%CI)分别为2.59(2.40~2.79)、1.45(1.40~1.50)、2.83(2.21~3.62)、2.18(1.69~2.81)、1.26(1.13~1.40)及1.26(1.07~1.48)。结论孕前BMI和孕期增重均是剖宫产、妊娠期高血压、子痫前期/子痫、低出生体重和巨大儿发生的影响因素,因此将孕前BMI、孕期增重控制在合理范围有利于获得良好的围生结局。Objective To investigate the effects of pre-pregnancy body mass index(BMI)and gestational weight gain on pregnancy outcomes,in order to provide evidence for pregnancy health care and prenatal weight management.Method A historical cohort study of 95849 single full-term pregnant women from 26 midwifery hospitals in Longgang District of Shenzhen City from 2014 to 2017 was conducted on the influence of pre-pregnancy BMI and gestational weight gain on perinatal outcomes.Results The average pre-pregnancy BMI was(20.49±2.83)kg/m2 in 95849 pregnant women,the average gestational weight gain was(14.49±5.89)kg.Compared with pregnant women with normal BMI and suitable weight gain during pregnancy,the emaciation(BMI<18.5 kg/m2)(OR=1.80,95%CI:1.61-2.00)and insufficient gestational weight gain(OR=1.83,95%CI:1.63-2.05)were risk factors for low birth weight infants.Pre-pregnancy overweight(BMI≥24 kg/m2)was a risk factor for gestational diabetes mellitus(GDM)(OR=1.84,95%CI:1.68-2.02),gestational hypertension(OR=2.40,95%CI:1.90-3.04),preeclampsia/eclampsia(OR=3.07,95%CI:2.39-3.96),macrosomia(OR=2.70,95%CI:2.49-2.92),cesarean section(OR=1.89,95%CI:1.81-1.97),birth asphyxia(OR=1.33,95%CI:1.05-1.67).Excessive weight gain during pregnancy was a risk factor for macrosomia(OR=2.59,95%CI:2.40-2.79),cesarean section(OR=1.45,95%CI:1.40-1.50),pregnancy hypertension(OR=2.83,95%CI:2.21-3.62),preeclampsia/eclampsia(OR=2.18,95%CI:1.69-2.81),premature rupture of membranes(OR=1.26,95%CI:1.13-1.40)and postpartum hemorrhage(OR=1.26,95%CI:1.07-1.48).Conclusions Pre-pregnancy BMI and pregnancy weight gain are the influencing factors of cesarean section,gestational hypertension,preeclampsia/eclampsia,low birth weight and macrosomia.Therefore,it will be conducive to a good pregnancy outcome by controlling pre-pregnancy BMI and gestational weight gain.

关 键 词：孕前体重指数 孕期增重 妊娠并发症 低出生体重 巨大儿 

分 类 号：R714.14[医药卫生—妇产科学]