孕前体质指数和孕期增重对妊娠期并发症及分娩结局的影响  

Influence of the pre-pregnancy body mass index and the weight gain during pregnancy of pregnant women on their pregnancy complications and delivery outcomes

作　　者：杨慧丽 郭翠梅 张凌云 宋秀云 YANG Huili;GUO Cuimei;ZHANG Lingyun;SONG Xiuyun(Qingdao Jiaozhou Central Hospital,Qingdao,Shandong Province,266300)

机构地区：[1]青岛市胶州中心医院,266300

出　　处：《中国计划生育学杂志》2025年第4期884-890,共7页Chinese Journal of Family Planning

基　　金：青岛市医疗卫生重点学科建设项目。

摘　　要：目的:探讨孕前体质指数(BMI)和孕期增重对妊娠期并发症及分娩结局的影响。方法:回顾性收集2021年1月-2023年10月本院分娩的产妇786例临床资料,按孕前BMI分为低体重组(BMI<18.5 kg/m^(2),n=102)、正常组(18.5≤BMI<24.0 kg/m^(2),n=518)、超重组(24.0≤BMI<28.0 kg/m^(2),n=125)、肥胖组(BMI≥28.0kg/m^(2),n=41),统计孕妇孕期增重情况,并对比各组并发症及分娩结局。结果:与孕前BMI正常组比较,低体重组妊娠期贫血、胎儿窘迫、新生儿窒息、产后出血、早产的发生率均较高;超重组妊娠期糖尿病、妊娠高血压疾病、妊娠期贫血、剖宫产、胎儿窘迫、新生儿窒息、产后出血、软产道裂伤发生率均较高;肥胖组妊娠期糖尿病、妊娠高血压疾病、妊娠期贫血、剖宫产、胎儿窘迫、新生儿窒息、巨大儿、产后出血发生率均较高(均P<0.05)。本研究786例孕妇中有51.9%的孕妇孕期体重管理不当,其中增重不足占16.5%,增重过多占35.4%,低体重组、超重组及肥胖组孕期增重不当比例均高于正常组(P<0.05)。与孕期增重适宜孕妇比较,增重不足孕妇的妊娠期贫血、剖宫产、胎儿窘迫、新生儿窒息、足月低体重儿、产后出血、软产道裂伤、早产发生率均较高;增重过多孕妇的妊娠期糖尿病、妊娠高血压疾病、妊娠期贫血、剖宫产、胎儿窘迫、新生儿窒息、巨大儿、足月低体重儿、产后出血、软产道裂伤的发生率均较高(均P<0.05)。spearman相关性分析显示,超重组、肥胖组增重过多孕妇的孕期增重值与妊娠期糖尿病、妊娠高血压疾病均呈正相关,肥胖组孕期增重过多孕妇的增重值与妊娠贫血呈正相关,低体重组孕期增重不足孕妇增重值与妊娠期贫血呈负相关(均P<0.05)。结论:孕妇孕前低体重、超重及孕期增重不足、增重过多均会增加妊娠风险,其中孕前低体重或增重不足增加妊娠期贫血、早产等风险,孕前超重或增Objective:To explore the influence of the pre-pregnancy body mass index(BMI)and the weight gain during pregnancy of pregnant women on their pregnancy complications and delivery outcomes.Methods:The clinical data of 786 pregnant women who gave birth in the hospital from January 2021 to October 2023 were collected retrospectively.According to the pre-pregnancy BMI,these women were divided into group A(102 women with pre-pregnancy BMI<18.5 kg/m^(2)),group B(518 women with 18.5≤BMI<24.0 kg/m^(2)),group C(125 women with 24.0≤pre-pregnancy BMI<28.0 kg/m^(2))and group D(41 women with pre-pregnancy BMI≥28.0 kg/m^(2)).The weight gain of the women in the four groups during pregnancy was counted.The complications rate and the delivery outcomes of the women were compared among the four groups.Results:The incidences of the anemia during pregnancy,the fetal distress,the neonatal asphyxia,the postpartum hemorrhage and the premature delivery of the women in group A were significantly higher than those of the women in group B.The incidences of the gestational diabetes mellitus(GDM),the hypertensive disorders complicating pregnancy(HDCP),the anemia of pregnancy,the cesarean section,the fetal distress,the neonatal asphyxia,the postpartum hemorrhage and the soft birth canal laceration of the women in group C were significantly higher than those of the women in group B.The incidences of the GDM,the HDCP,the anemia of pregnancy,the cesarean section,the fetal distress,the neonatal asphyxia,the macrosomia and the postpartum hemorrhage of the women in group D were significantly higher than those of the women in group B(all P<0.05).In 786pregnant women,there were 51.9%women with the inappropriate weight management during pregnancy,including16.5%women with the inadequate weight gain during pregnancy and 35.4%women with the excessive weight gain during pregnancy.The proportion of the inappropriate weight gain during pregnancy of the women in group A,in group C or in group D was significantly higher than that of the women in group B(P<

关 键 词：孕期增重 孕前体质指数 妊娠期并发症 分娩结局 相关性 

分 类 号：R714.2[医药卫生—妇产科学] R714.7[医药卫生—临床医学]