孕前BMI对妊娠合并症和妊娠结局的影响  

Effect of pre-pregnant body mass index on pregnancy complications and outcomes

作　　者：贾朝霞[1] 赵永鲜[1] 黄丽丽[1] 赵曼 邹晓璇[3] 武明辉[1] JIA Zhaoxia;ZHAO Yongxian;HUANG Lili;ZHAO Man;ZOU Xiaoxuan;WU Minghui(Beijing Obstetrics and Gynecology Hospital/Beijing Maternal and Child Health Care Hospital,Capital Medical University,Beijing 100026,China;Beijing Chaoyang Disrict Maternal and Child Health Care Hospital,Beijing 100021,China;Beijing Haidian District Maternal and Child Health Care Hospital,Beijing 100080,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院,北京100026 [2]北京市朝阳区妇幼保健院,北京100021 [3]北京市海淀区妇幼保健院,北京100080

出　　处：《中国妇幼健康研究》2023年第3期69-73,共5页Chinese Journal of Woman and Child Health Research

基　　金：中国疾病预防控制中心妇幼保健中心—母婴营养与健康研究项目(2019FYH001)。

摘　　要：目的 评估产妇孕前体重指数(BMI)对妊娠合并症和并发症的影响。方法 采用回顾性队列研究的方法,从北京市6家助产机构中按顺序入组2016年10月至2017年3月分娩的产妇。从产检和分娩病历中获取孕妇的孕前BMI并进行分组,并记录孕期和分娩时相关信息。结果 共纳入6 639名产妇,其中16.28%的产妇孕前超重,4.62%的产妇孕前肥胖。Logistic回归分析显示,调整了其他危险因素后,与孕前体重正常组相比,孕前低体重会增加新生儿出生后1周内转入NICU的风险(OR=1.53,P<0.05);而孕前超重、孕前肥胖增加了剖宫产(OR值分别为1.21、1.49)、子痫前期(OR值分别为2.67、9.05)、GDM(OR值分别为1.26、2.05)、产后出血(OR值分别为1.39、1.49)、巨大儿(OR值分别为1.74、2.67)的发生风险(P<0.05)。1 519例(23.14%)产妇在孕期增重不足,2 742例(41.77%)产妇增重合理,2 303例(35.09%)产妇增重过多;孕前BMI越高,孕期增重过多的比例越大,增重合理的比例越低(趋势χ^(2)检验:χ^(2)=5.614,P<0.05)。结论 孕前BMI过高或者过低都会增加妊娠合并症和并发症的发生风险,但是目前孕前BMI过高的孕妇,其孕期体重管理并不理想。尚需要加强孕前和妊娠期体重的管理,以降低妊娠合并症和并发症的发生。Objective To assess effect of pre-pregnant body mass index(BMI) on pregnancy complications and outcomes.Methods A retrospective cohort study was conducted.The pregnant and parturient women who delivered in 6 midwifery institutions in Beijing from October 2016 to March 2017 were sequentially recruited.Pre-pregnant BMI of the subjects was obtained from obstetric and delivery medical records, and other information of the subjects in pregnancy and delivery were also recorded.Results A total of 6639 parturients were recruited.16.3% of the parturients had overweight before pregnancy and 4.6% of the parturients had obesity before pregnancy according to their pre-pregnant BMI.Logic regression analysis shown that as compared with the risks in the parturients with normal pre-pregnant BMI,after adjusted other risk factors, low pre-pregnant body weight increased the risk of the newborns transferring to neonatal intensive care unit(NICU)(OR=1.53,P<0.05),while pre-pregnant overweight or obesity could increase the risks of cesarean section [OR(normal pre-pregnant BMI vs pre-pregnant overweight or obesity):1.21 vs 1.49, P<0.05],preeclampsia(OR:2.67 vs 9.05,P<0.001),gestational diabetes mellitus(GDM)(OR:1.26 vs 2.05,P<0.05),postpartum hemorrhage(OR:1.39 vs 1.49,P<0.05),macrosomia(OR:1.74 vs 2.67,P<0.001).Conclusion Both high and low pre-pregnant BMI increase the risk of pregnancy complications.However, at present, for those pregnant women with high pre-pregnant BMI,gestational weight management is not optimal, so, management of pre-pregnant body weight and gestational weight gain should be strengthened to reduce development of pregnancy complications.

关 键 词：孕前体重指数 孕期增重 妊娠合并症 妊娠结局 

分 类 号：R173[医药卫生—妇幼卫生保健]