目的 分析孕前体重指数(BMI)及孕期体重增长对围生结局的影响,为孕期保健、孕前和孕期体重管理提供依据。方法 采用历史性队列研究方法,将深圳市龙岗区2014-2017年26家助产医院95 849例单胎足月产妇按孕前BMI及孕期增重情况分组,观察各组围生结局。结果 95 849例孕妇平均孕前BMI为(20.49±2.83) kg/m2,平均孕期增重(14.49±5.89) kg。相比孕前正常BMI 和孕期增重适宜的孕妇,孕前消瘦(BMI<18.5kg/m2)和孕期增重不足是低出生体重儿发生的危险因素,OR值(95%CI)分别为1.80(1.61~2.00)、1.83(1.63~2.05);孕前超重(BMI≥24 kg/m2)是妊娠期糖尿病(GDM)、妊娠期高血压、子痫前期/子痫、巨大儿、剖宫产、出生窒息发生的危险因素,OR值(95%CI)分别为1.84(1.68~2.02)、2.40(1.90~3.04)、3.07(2.39~3.96)、2.70(2.49~2.92)、1.89(1.81~1.97)及1.33(1.05~1.67);孕期增重过度是巨大儿、剖宫产、妊娠期高血压、子痫前期/子痫、胎膜早破、产后出血发生的危险因素,OR值(95%CI)分别为2.59(2.40~2.79)、1.45(1.40~1.50)、2.83(2.21~3.62)、2.18(1.69~2.81)、1.26(1.13~1.40)及1.26(1.07~1.48)。结论 孕前BMI和孕期增重均是剖宫产、妊娠期高血压、子痫前期/子痫、低出生体重和巨大儿发生的影响因素,因此将孕前BMI、孕期增重控制在合理范围有利于获得良好的围生结局。
Abstract
Objective To investigate the effects of pre-pregnancy body mass index (BMI) and gestational weight gain on pregnancy outcomes,in order to provide evidence for pregnancy health care and prenatal weight management. Method A historical cohort study of 95 849 single full-term pregnant women from 26 midwifery hospitals in Longgang District of Shenzhen City from 2014 to 2017 was conducted on the influence of pre-pregnancy BMI and gestational weight gain on perinatal outcomes. Results The average pre-pregnancy BMI was (20.49±2.83) kg/m2 in 95 849 pregnant women,the average gestational weight gain was (14.49 ±5.89) kg.Compared with pregnant women with normal BMI and suitable weight gain during pregnancy,the emaciation (BMI<18.5 kg/m2) (OR=1.80,95%CI: 1.61-2.00) and insufficient gestational weight gain (OR=1.83,95%CI: 1.63-2.05) were risk factors for low birth weight infants.Pre-pregnancy overweight (BMI≥24 kg/m2) was a risk factor for gestational diabetes mellitus (GDM) (OR=1.84,95%CI: 1.68-2.02),gestational hypertension(OR=2.40,95%CI: 1.90-3.04),preeclampsia/eclampsia(OR=3.07,95%CI: 2.39-3.96),macrosomia(OR=2.70,95%CI: 2.49-2.92),cesarean section(OR=1.89,95%CI: 1.81-1.97),birth asphyxia(OR=1.33,95%CI: 1.05-1.67).Excessive weight gain during pregnancy was a risk factor for macrosomia (OR=2.59,95%CI: 2.40-2.79),cesarean section(OR=1.45,95%CI: 1.40-1.50),pregnancy hypertension (OR=2.83,95%CI: 2.21-3.62),preeclampsia/eclampsia(OR=2.18,95%CI: 1.69-2.81),premature rupture of membranes(OR=1.26,95%CI: 1.13-1.40) and postpartum hemorrhage(OR=1.26,95%CI: 1.07-1.48). Conclusionss Pre-pregnancy BMI and pregnancy weight gain are the influencing factors of cesarean section,gestational hypertension,preeclampsia/eclampsia,low birth weight and macrosomia.Therefore,it will be conducive to a good pregnancy outcome by controlling pre-pregnancy BMI and gestational weight gain.
关键词
孕前体重指数 /
孕期增重 /
妊娠并发症 /
低出生体重 /
巨大儿
Key words
pre-pregnancy body mass /
gestational weight gain /
pregnancy complications /
low birth weight /
macrosomia
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基金
深圳市龙岗区科技计划项目(LGKCYLWS2018000217)
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