妊娠不同时期体成分指标的变化及对新生儿低出生体质量的预测价值  

Changes of body composition indexes in different periods of pregnancy and its predictive value for low birth weight of newborns

作　　者：李静[1] 韦海棠 张春[1] 张继红[1] Li Jing;Wei Haitang;Zhang Chun;Zhang Jihong(Department of Obstetrics,Guangxi Zhuang Autonomous Region People’s Hospital,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院产科,南宁530021

出　　处：《中国医药》2020年第10期1611-1615,共5页China Medicine

基　　金：广西壮族自治区卫生和计划生育委员会课题(Z20170365)。

摘　　要：目的探讨妊娠不同时期体成分指标的变化情况,分析体成分指标与新生儿体质量的相关性以及对新生儿低出生体质量的预测价值。方法选择2017年3月至2018年3月在广西壮族自治区人民医院产科规范进行产前检查,并随访至分娩的单胎孕妇547例。分别于妊娠8周内、妊娠12-14周、妊娠20-24周、妊娠28-32周和妊娠36周后应用生物电阻抗技术进行体成分检测,记录体脂质量、体重指数、体脂百分比(PBF)、去脂质量及基础代谢率(BMR)。应用线性回归分析妊娠不同时期体成分指标与新生儿体质量间的关系,绘制受试者工作特征曲线分析体成分指标对新生儿低出生体质量的预测价值。结果随着孕周的增加,体成分指标:体脂质量、去脂质量、体重指数、PBF和BMR逐渐增加,但妊娠36周后与妊娠28-32周比较,仅去脂质量和BMR明显增加(均P <0.05),体脂质量、体重指数和PBF比较,差异均无统计学意义(均P> 0.05)。线性回归分析结果表明,新生儿体质量与妊娠8周内、妊娠20-24周、妊娠28-32周和妊娠36周后去脂质量呈正相关,与妊娠8周内、妊娠12-14周、妊娠20-24周、妊娠28-32周体重指数呈负相关(均P <0.05)。受试者工作特征曲线结果表明,体脂质量在妊娠8周内、妊娠12-14周、妊娠20-24周、妊娠28-32周对新生儿低出生体质量的预测价值最大,最佳截断值分别为15.35、15.35、15.75、17.05 kg;妊娠36周后BMR对新生儿低出生体质量的预测价值最大,最佳截断值为1 273.5 k J。结论利用孕妇体成分检测分析监测孕期营养,有助于预测新生儿低出生体质量,及时采取干预措施有助于改善围产儿质量。Objective To explore the changes of body composition index in different periods of pregnancy,analyze the correlation between body composition index and body mass of newborn,and predict the value of low body mass of newborn.Methods From March 2017 to March 2018,547 singleton pregnant women were selected for prenatal examination in the obstetric standard of Guangxi Zhuang Autonomous Region People’s Hospital and followed up to delivery.The body composition was measured by bioelectrical impedance technique in 8 weeks,12-14 weeks,20-24 weeks,28-32 weeks and 36 weeks respectively,and the body fat mass,body mass index,percentage of body fat(PBF),degreasing mass and basal metabolic rate(BMR)were recorded.Linear regression was used to analyze the relationship between the body composition index and the body mass of the newborn at different time of pregnancy.Results With the increase of gestational weeks,the body composition index,body fat mass,body mass index,PBF and BMR increased gradually;but after 36 weeks of gestation,compared with28-32 weeks of gestation,only the body fat mass and BMR increased significantly(all P<0.05),the body fat mass,body mass index and PBF had no statistical significance(all P>0.05).The results of linear regression analysis showed that the body mass of newborn was positively correlated with the quality of fat removal within8 weeks of pregnancy,20-24 weeks of pregnancy,28-32 weeks of pregnancy and 36 weeks of pregnancy,and negatively correlated with the body mass index within 8 weeks of pregnancy,12-14 weeks of pregnancy,20-24 weeks of pregnancy and 28-32 weeks of pregnancy.The results of work characteristic curve showed that the prediction value of body fat mass to low birth weight was the highest in 8 weeks of pregnancy,12-14 weeks of pregnancy,20-24 weeks of pregnancy and 28-32 weeks of pregnancy,with the best cut-off values of 15.35,15.35,15.75 and17.05 kg,respectively;the prediction value of BMR to low birth weight was the highest after 36 weeks of pregnancy,with the best cut-off value of 1

关 键 词：体成分 生物电阻抗 低出生体质量 妊娠 

分 类 号：R173[医药卫生—妇幼卫生保健]