摘要
目的用基于孕前体质指数(BMI)的孕期增重指导作为干预手段,探讨孕前BMI与孕期增重对胎儿出生体重的影响。方法采用前瞻性开放性对照研究,将上海市闵行区两家医院产检孕妇9 018例非随机地分为干预组(4899例)和对照组(4 119例)。干预组给与研究对象孕期增重适宜范围的指导;对照组按原来标准产前检查进行,不开展任何关于孕期增重方面的指导。比较两组婴儿出生体重、巨大儿发生率,多因素Logistic回归法分析巨大儿发生率的影响因素。结果多因素Logistic分析结果显示,偏瘦组(BMI<18.5 kg/m2)和超重组(BMI≥24 kg/m^2)的巨大儿发生率分别是正常体重组(BMI 18.5~23.9 kg/m^2)的0.711、1.555倍。母亲的怀孕年龄每增加一岁,其分娩巨大儿的危险增加3.7%。经产妇分娩巨大儿的风险会降低17.1%;孕周每增加一周,巨大儿发生率增加9.1%。孕期增重指导的干预手段可明显降低巨大儿发生率,干预组巨大儿的危险度是对照组0.836倍(95%CI:0.67~0.99)。结论巨大儿与孕妇年龄、孕前BMI、孕期增重、孕周及产次有关。基于孕前BMI的孕期增重指导可降低巨大儿发生率。
Objective To explore the effect of pregnant weight gain intervention on reducing risk of macrosomia and to study the relationship among pre-pregnant BMI,weight gain and birth weight. Methods As an open controlled trial,pregnant women from two hospitals were randomly divided into intervention group（ n = 4899） and control group（ n = 4119）. Pregnant wemen in intervention group were accepted with the guidance on pregnant weight gain by pre-pregnancy BMI. Birth weight and incidence of macrosomia were compared between these two groups.Risk factors for macrosomia were analyzed via Logistic regression. Results Logistic analysis showed that risk factors for macrosomia in women with BMI 18. 5 and BMI≥24 were 0. 711,they were 1. 555-fold than those with BMI between 18. 5 and 23. 9. The incidence of macrosomia increased 3. 7% as the growing of maternal age. The recommended guideline for gestational weight gain on the basis of pre-pregnancy BMI could reduce the incidence of macrosomia（ RR = 0. 836,95% CI： 0. 67 - 0. 99）. Conclusion Macrosomia is closely related to the age of pregnant women,BMI before pregnancy,gestational weight gain,gestational weeks and parity. The recommended guideline for gestational weight gain by pre-pregnancy BMI can reduce the incidence of macrosomia.
出处
《临床和实验医学杂志》
2018年第4期434-437,共4页
Journal of Clinical and Experimental Medicine
基金
上海市闵行区科委课题项目(编号:2014MHZ003)
上海市卫生和计划生育委员会科研课题青年项目(编号:YZ15-52-1)
关键词
巨大儿
孕期增重
孕前BMI
非随机对照干预试验
上海
Macrosomia
Gestational weight gain
Pre-pregnancy body mass index
Non-randomized controlled intervention study
Shanghai
