不同孕前BMI和妊娠期体重增长初产妇妊娠和新生儿结局分析  

Analysis of pregnancy and neonatal outcomes in primiparas with different pre-pregnancy BMI and gestational weight gain

作　　者：杨彩霞[1] YANG Caixia(Department of Obstetrics,Tianjin Baodi Hospital(Tianjin Medical University Baodi Hospital),Tianjin 301800,CHINA)

机构地区：[1]天津市宝坻区人民医院(天津医科大学附属宝坻医院)产科,301800

出　　处：《江苏医药》2024年第10期1051-1055,共5页Jiangsu Medical Journal

摘　　要：目的分析不同孕前BMI和妊娠期体重增长(GWG)初产妇的妊娠及新生儿结局。方法回顾性分析3531例初产妇的临床资料。按照孕前BMI,初产妇分为A组(低体重,BMI<18.5kg/m^(2),373例)、B组(正常体重,18.5kg/m^(2)≤BMI<24.0kg/m^(2),1986例)、C组(超重,24.0kg/m^(2)≤BMI<28.0kg/m^(2),766例)和D组(肥胖,BMI≥28.0kg/m^(2),406例);根据GWG,A组进一步分为A1组(GWG<11.0kg)、A2组(11.0kg≤GWG≤16.0kg)和A3组(GWG>16.0kg);B组进一步分为B1组(GWG<8.0kg)、B2组(8.0kg≤GWG≤14.0kg)和B3组(GWG>14.0kg);C组进一步分为C1组(GWG<7.0kg)、C2组(7.0kg≤GWG≤11.0kg)和C3组(GWG>11.0kg);D组进一步分为D1组(GWG<5.0kg)、D2组(5.0kg≤GWG≤9.0kg)和D3组(GWG>9.0kg)。比较各组一般资料、妊娠结局及新生儿结局。结果B、C、D组年龄、分娩前体重、分娩前BMI和新生儿体重高于A组,D组GWG低于A、B、C组,C、D组分娩前体重、分娩前BMI高于B组(P<0.05)。A、B、C、D组剖宫产、妊娠期高血压疾病、妊娠期高血糖、早产、巨大儿、低体重儿比例均有统计学差异(P<0.05)。不同GWG初产妇剖宫产、妊娠期高血压疾病、妊娠期高血糖、早产、巨大儿、低体重儿比例有统计学差异(P<0.05)。结论孕前BMI和GWG与妊娠结局及新生儿结局密切相关。加强孕前及妊娠期管理,控制孕前BMI在正常范围,合理控制GWG,可有效改善妊娠结局及新生儿结局。Objective To analyze the pregnancy and neonatal outcomes of the primiparas with different pre-pregnancy BMI and gestational weight gain(GWG).Methods The clinical data of 3531 primiparas were retrospectively analyzed.According to pre-pregnancy BMI,the primiparas were divided into groups of A(BMI<18.5kg/m^(2),373cases),B(18.5kg/m^(2)≤BMI<24.0kg/m^(2),1986cases),C(24.0kg/m^(2)≤BMI<28.0kg/m^(2),766cases)and D(BMI≥28.0kg/m^(2),406cases).According to GWG,group A was subdivided into groups of A1(GWG<11.0kg),A2(11.0kg≤GWG≤16.0kg)and A3(GWG>16.0kg),group B was subdivided into groups of B1(GWG<8.0kg),B2(8.0kg≤GWG≤14.0kg)and B3(GWG>14.0kg),group C was subdivided into groups of C1(GWG<7.0kg),C2(7.0kg≤GWG≤11.0kg)and C3(GWG>11.0kg),and group D was subdivided into groups of D1(GWG<5.0kg),D2(5.0kg≤GWG≤9.0kg)and D3(GWG>9.0kg).The general data,pregnancy and neonatal outcomes were compared among the groups.Results The age,pre-delivery weight,pre-delivery BMI and neonatal weight in groups of B,C and D were higher than those in group A(P<0.05).GWG was lower in group D than that in groups of A,B and C(P<0.05).The pre-delivery weight and pre-delivery BMI in group C and group D were higher than those in group B(P<0.05).There were significant differences in the proportions of Cesarean section,gestational hypertension,gestational hyperglycemia,preterm birth,macrosomia and low birth weight among the groups of A,B,C and D(P<0.05).There were statistical differences in the proportions of Cesarean section,gestational hypertension,gestational hyperglycemia,preterm birth,macrosomia and low birth weight among the different GWG primiparas groups(P<0.05).Conclusion Pre-pregnancy BMI and GWG are closely related to the pregnancy and newborn outcomes.Strengthening pre-pregnancy and pregnancy management,controlling pre-pregnancy BMI within normal range and rationally controlling pregnancy weight gain can effectively improve the pregnancy and newborn outcomes.

关 键 词：体重指数 妊娠期体重增长 初产妇 

分 类 号：R714[医药卫生—妇产科学]