孕前体重指数及孕期体重变化量对妊娠并发症及妊娠结局的影响

Study on the influence of pre-pregnancy body mass index and gestational weight gain on pregnancy complications and pregnancy outcomes

目的探究孕前体重指数(BMI)及孕期体重变化量(GWG)对妊娠并发症和妊娠结局的影响。方法选择2022年1~12月在我院建档并分娩的孕产妇1019例为研究对象,其中高龄孕产妇204例。根据孕前BMI分为孕前肥胖组、孕前超重组、孕前正常体重组、孕前低体重组;根据GWG分为过少GWG组、适宜GWG组和过多GWG组,统计分析临床资料,比较组间妊娠并发症和妊娠结局情况。结果孕前BMI越高,妊娠期糖尿病(GDM)、妊娠期高血压疾病(HDP)及巨大儿的发病率越高;不同GWG组间GDM、早产(PTB)的发病率比较差异有统计学意义(P<0.05),过少GWG组GDM及PTB的患病率最高;在高龄患者中,各组间HDP及PTB的发病率比较差异有统计学意义(P<0.05),孕前超重组HDP及PTB的发病率高于孕前正常体重组;高龄孕产妇中PTB的发病率在不同GWG组间有统计学差异(P<0.05),过少GWG组PTB的发病率最高。结论孕前减重及适宜的GWG对降低孕前肥胖及超重的女性不良围产期并发症及子代肥胖等代谢性疾病的发病率至关重要,应充分发挥营养门诊的作用,通过健康宣教提高孕产妇依从性,提高母婴安全和健康。

Objective To explore the influence of pre-pregnancy body mass index(BMI)and gestational weight gain(GWG)on pregnancy complications and pregnancy outcomes.Methods A total of 1019 pregnant women medical record were collected for the period from Jan to Dec 2022,who were registered and gave birth in our hospital,including 204 elderly pregnant women.According to the pre-pregnancy BMI and GWG,the pregnant women were divided into pre-pregnancy obesity group,pre-pregnancy overweight group,pre-pregnancy normal weight group and pre-pregnancy low weight group,as well as too little GWG group,appropriate GWG group and too much GWG group respectively.Clinical data were also collected to compare the occurrence of pregnancy complications among the groups.Results The higher the pre-pregnancy BMI,the higher the incidence of gestational diabetes mellitus(GDM),hypertensive disorders of pregnancy(HDP)and macrosomia.There were statistical differences in the incidence of GDM and preterm birth(PTB)among different GWG groups(P<0.05),and the prevalence of GDM and PTB was the highest in the too little GWG group.In elderly patients,there were statistically significant differences in the incidence of HDP and PTB among all groups(P<0.05),and the incidence of pre-pregnancy overweight was higher than that of pre-pregnancy normal weight group.The incidence of PTB in elderly pregnant women was statistically different among GWG groups(P<0.05),and the PTB incidence was the highest in the too little GWG group.Conclusion Prepregnancy weight reduction and appropriate GWG during pregnancy are essential to reduce the incidence of adverse perinatal complications and metabolic diseases,such as offspring obesity in pre-pregnancy obese and overweight women,The nutrition clinics should be improve maternal compliance through health education,protecting maternal and infant safety.