肥胖孕妇分娩新生儿的体脂率及其影响因素  

Analysis of body fat percentage and its influencing factors of neonates delivered by obese pregnant women

作　　者：叶樱琳 郭晓蒙 郑燕伟[1] 蒋荣珍[1] Ye Yinglin;Guo Xiaomeng;Zheng Yanwei;Jiang Rongzhen(Department of Obstetrics and Gynecology,Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院妇产科,200233

出　　处：《中华妇幼临床医学杂志（电子版）》2021年第5期536-544,共9页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家自然科学基金资助项目(81570444);上海市卫生计生委第四轮公共卫生行动计划重点学科建设计划(15GWZK0701);上海市科技创新行动计划(17411950602)。

摘　　要：目的探讨不同人体质量指数(BMI)孕妇分娩新生儿的体脂率及其相关影响因素。方法选择2019年1月至2020年1月,于上海市第六人民医院采取择期剖宫产术分娩的77例单胎、足月妊娠孕妇为研究对象。根据孕妇分娩前的BMI值,将其分为肥胖组(n=28,BMI≥30.0 kg/m2),超重组(n=33,25.0 kg/m2≤BMI<30.0 kg/m2)及正常组(n=16,18.5 kg/m2≤BMI<25.0 kg/m2)。采集孕妇分娩前空腹外周静脉血及分娩时新生儿脐静脉血各5 mL,分别对孕妇及新生儿空腹血糖(FPG)、空腹胰岛素(FINS)及血脂水平进行检测。采用Kruskal-Wallis H检验、单因素方差分析及最小显著性差异法(LSD)-t,对3组孕妇一般临床资料,新生儿出生体重及体脂率,孕妇孕期血糖、血脂水平,孕妇分娩前及新生儿FPG、FINS及血脂水平,进行总体及两两比较。对于与新生儿出生体重、体脂率的相关因素分析,采用Pearson直线相关分析及Spearman秩相关分析法(分娩孕龄)。进一步采用多重线性回归分析,推导新生儿体脂率相关因素的多重线性回归方程。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》,与所有受试者签署临床研究知情同意书。3组孕妇年龄、身高、孕期增重等一般临床资料比较,差异均无统计学意义(P>0.05)。结果①3组孕妇孕前体重及BMI、分娩前体重及BMI,以及新生儿体脂率比较,差异均有统计学意义(P<0.001),其中肥胖组这5项指标最高,正常组最低。3组新生儿出生体重比较,差异无统计学意义(P>0.05)。②肥胖组及超重组孕妇晚孕期FPG水平分别为(4.8±0.7)mmol/L、(4.7±0.4)mmol/L,均分别高于正常组的(4.3±0.4)mmol/L,并且差异均有统计学意义(P=0.001、0.008)。3组孕妇早、中、晚孕期其余血糖指标,总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)及低密度脂蛋白(LDL)水平比较,差异均无统计学意义(P>0.05)。③肥胖组孕妇分娩前血清FINS及游离脂肪�Objective To investigate body fat percentage and influencing factors of neonates delivered by pregnant women with different body mass index(BMI).Methods From January 2019 to January 2020,a total of 77 cases of singleton,full-term pregnant women who gave birth by elective cesarean section in Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University were selected as research subjects.They were divided into obese group(n=28,BMI≥30.0 kg/m2),overweight group(n=33,25.0 kg/m2≤BMI<30.0 kg/m2)and normal group(n=16,18.5 kg/m2≤BMI<25.0 kg/m2)according to BMI of pregnant women before delivery.Collection of 5 mL fasting peripheral venous blood of pregnant women before delivery and 5 mL umbilical venous blood of neonates during delivery,and levels of fasting plasma glucose(FPG),fasting insulin(FINS)and blood lipids of pregnant women and their neonates were detected.The general clinical data,neonatal birth weight and body fat percentage,blood glucose and blood lipids levels of pregnant women during pregnancy;FPG,FINS and blood lipids levels of pregnant women before delivery and neonatal among three groups were compared statistically overall by Kruskal-Wallis H test or one-way ANOVA and pairwise by least significant difference(LSD)-t test.The correlation with neonatal birth weight and body fat percentage were investigated by Pearson linear correlation analysis and Spearman rank correlation analysis(gestational age).A multiple linear regression equation of neonatal body fat percentage with influencing factors was derived by multiple linear regression analysis.This study was in line with the World Medical Association Declaration of Helsinki revised in 2013,and all subjects signed the informed consents of clinical research.There were no significant differences in age,height,gestational weight gain of pregnant women among three groups(P>0.05).Results①There were significant differences in weight and BMI pre-pregnant and pre-delivery of pregnant women,and neonatal body fat percentage among three groups(P<0

关 键 词：人体质量指数 肥胖症 血脂 血糖 体脂肪率 孕妇 婴儿 新生 

分 类 号：R71[医药卫生—妇产科学]