孕前、产前体重指数和孕期增重对高龄产妇妊娠并发症及结局的影响  

Impacts of pre-pregnancy and prenatal body mass index,and weight gain during pregnancy on pregnancy complications and outcomes of elderly parturients

作　　者：刘滔 张婷[1] 欧阳玲[1] 李艳容[1] LIU Tao;ZHANG Ting;OUYANG Ling;LI Yanrong(Department of Obstetrics and Gynecology,Changsha Central Hospital,Hu'nan,Changsha 410004,China)

机构地区：[1]长沙市中心医院妇产科,湖南长沙410004

出　　处：《中国医药科学》2020年第18期1-5,共5页China Medicine And Pharmacy

基　　金：湖南省卫生健康委员会科研立项课题(20201965)。

摘　　要：目的探讨孕前、产前体重指数及孕期增重对高龄产妇妊娠并发症及妊娠结局的影响。方法采用回顾性研究方法,分析2018年8月~2019年7月在长沙市某三甲医院产科分娩的385例高龄单活胎产妇病例资料。按孕前BMI分为消瘦、正常、超重、肥胖四组,按孕期体重增加标准分为增重不足、增重正常、增重过度三组,按产前BMI分为A、B、C、D四组,分析不同组间高龄产妇的剖宫产率、妊娠并发症及不良妊娠结局的差异。结果(1)不同孕前BMI高龄产妇的剖宫产、妊娠期糖尿病、妊娠期高血压、子痫前期、巨大儿的发生率比较,差异有统计学意义(P<0.05),且随着孕前BMI增加,剖宫产和妊娠期糖尿病的发生率有上升趋势。(2)不同孕期体重增加组孕妇的剖宫产率、妊娠期糖尿病、子痫前期、羊水过少、巨大儿、低出生体重儿的发生率比较,差异有统计学意义(P<0.05),且随着孕期体重增长,剖宫产、子痫前期、巨大儿的发生率有上升趋势。(3)不同产前BMI高龄产妇的剖宫产、子痫前期、巨大儿、胎儿窘迫的发生率比较,差异有统计学意义(P<0.05)。结论孕前、产前体重指数过高及孕期增重过多是高龄产妇妊娠并发症及不良妊娠结局的重要因素。加强高龄孕妇孕前的体重评估,合理控制孕期体重增长和产前体重,能有效降低妊娠并发症及不良结局的发生风险。Objective To investigate the impacts of pre-pregnancy and prenatal body mass index,and weight gain during pregnancy on pregnancy complications and outcomes of elderly parturients.Methods The medical record data of 385 elderly parturients delivering a single live fetus in the obstetrics department of a 3A hospital in Changsha from August 2018 to July 2019 were analyzed by retrospective research method.According to the prepregnancy BMI,they were divided into 4 groups including the maransis group,the normal group,the overweight group and the obesity group.According to the weight gain during pregnancy,they were divided into 3 groups including the insufficient weight gain group,the normal weight gain group and the excessive weight gain group.According to the prenatal BMI,they were divided into 4 groups including group A,group B,group C and group D.The differences of cesarean section rate,pregnancy complications and adverse pregnancy outcomes among different groups were analyzed.Results(1)The differences in incidence rates of cesarean section,gestational diabetes mellitus,gestational hypertension,preeclampsia and macrosomia in elderly parturients with different pre-pregnancy BMI were statistically significant(P<0.05),and with the increase of pre-pregnancy BMI,the incidence rates of cesarean section and gestational diabetes mellitus increased.(2)The differences in incidence rates of cesarean section,gestational diabetes mellitus,preeclampsia,oligohydramnios,macrosomia and low birth weight infants in elderly parturients in different weight gain groups were statistically significant(P<0.05),and the incidences of cesarean section,preeclampsia and macrosomia increased with the increase of weight during pregnancy.(3)The differences in incidence rate of cesarean section,preeclampsia,macrosomia and fetal distress in elderly parturients with different prenatal BMI were significantly different(P<0.05).Conclusion High body mass index before and during pregnancy and excessive weight gain during pregnancy are important factors for

关 键 词：高龄孕产妇 体重指数 孕期增重 妊娠并发症 妊娠结局 

分 类 号：R714.25[医药卫生—妇产科学]