摘要
目的通过对孕前、孕早中晚各个阶段及整个孕期体质指数（BMI）增加速率与妊娠不良母婴结局间的关系进行研究，探讨不同孕前BMI及孕期不同阶段体质量增加情况对妊娠结局的影响，为临床孕妇体质量控制提供依据。方法随机选取2015年4月至2016年1月间，在浙江省台州市第一人民医院及黄岩区妇幼保健院初诊确定妊娠的孕妇共计964例进行前瞻性研究，以美国医学研究所2009年[IOM2009]规定的范围为分组标准：（1）根据孕前BMI将研究对象分成：A组：孕前低BMI组（即BMI〈18．5kg／m2）；B组：孕前正常BMI组（即BMI在18．5-24．9kg／m2）；C组：孕前超BMI组（即BMI在25～29．9kg／m2）；D组：孕前肥胖组（即BMI≥30kg／m2）。（2）根据孕早、中、晚及总孕期体质量增加速率分成：体质量增加正常组，体质量增加不足组，体质量增加过多组。（3）利用自制的信息表记录孕期增重情况、妊娠结局，包括妊娠期糖尿病（GDM）、新生儿出生体质量、妊娠期高血压疾病（HDCP）、剖宫产、产钳助产、肩难产、巨大儿、小于孕龄儿（SGA）、胎膜早破、新生儿窒息及新生儿低血糖的发生率。结果（1）本研究共纳入964例孕妇，孕前BMI不同的A、B、C、D各组孕妇年龄、文化层次、孕次及产次均差异无统计学意义（P〉0．05）。（2）分别以GDM、HDCP、胎膜早破、剖宫产、产钳、肩难产、巨大儿、SGA、新生儿窒息及新生儿低血糖发病是否作因变量，以孕不同阶段体质量增加为自变量，多因素Logistic回归分析：孕前肥胖是发生GDM、HDCP的危险因素，其OR值分别为6．63和2．60（均P〈0．05）；总孕期体质量增加过多是发生GDM、巨大儿及剖宫产的危险因素，其OR值分别是2．05、1．36和1．60（均P〈0．05）；余各组发生率差异均无统计学意义（均P〉0．05）。（3）孕前肥胖及孕早、中、晚及
Objective By investigating the relationship of pregestational body mass index（BMI）, trimester-specific gestational weight gain （rate） during the first, second, third and total trimesters of pregnancy with adverse pregnant outcomes, to evaluate the effects of different pregestational BMI, trimester- specific gestational weight gain on pregnant outcomes, and to provide evidences for gestational weight control. Methods From April 2015 to January 2016, 964 pregnant women in Zhejiang Taizhou First People＇ s Hospital and Taizhou Huangyan Maternal ＆ Child Care Service Center were enrolled in random for prospective study and were divided into groups according to the Institute of Medicine 2009 guidelines [ IOM20093. （ 1 ） They were divided into four groups according to pregestational BMI ：low body mass, normal body mass, over body mass and obese group. （2）They were divided into three groups according to trimester- specific gestational weight gain （rate） ： normal gestational weight gain, insufficient gestational weight gainand excessive gestational weight gain. （3）The gestational weight gain and pregnant outcomes were recorded by using self-made information table, including the incidence rates of gestational diabetes mellitus （GDM） , neonatal birth weight （BW） , hypertensive disorders complicating pregnancy （ HDCP）, cesarean section, pliers delivery, shoulder dystocia, fetal macrosomia, small for gestational age （SGA）, premature rupture of membranes, neonatal asphyxia, and neonatal hypoglycemia. Results （1）In this study, 964 pregnant women were enrolled, no significant differences were found in terms of age, culture level, pregnancy times and delivery times of the different pregestational BMI groups （ P 〉 0. 05 ）. （ 2 ） The incidences of GDM, HDCP, premature rupture of membranes, cesarean section, pliers delivery, shoulder dystocia, fetal macrosomia, SGA, neonatal asphyxia and neonatal hypoglycemia were as dependent variables and trimester- specific gestational
作者
陈晓璐
彭洋颖
徐雪清
Chen Xiaolu, Peng Yangying, Xu Xueqing.(Taizhou First People＇s Hospital, Zhejiang Taizhou 318020, Chin)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2018年第19期1493-1497,共5页
National Medical Journal of China
基金
2015年台州市科技计划项目（1501KY37）
关键词
妊娠
体质指数
糖尿病
妊娠结局
Pregnancy
Body mass index
Diabetes mellitus
Pregnant outcome
