孕前体重、孕期增重与妊高征及新生儿出生体重的关系

Relations of pre-pregnant weight and weight gain during pregnancy with pregnancy-induced hypertension and birth weight

目的探讨孕妇孕前体重(体质量)指数及孕期体重增加情况对妊高征及新生儿出生体重的影响。方法测量769例足月单胎初产妇孕前的身高、体重和孕期体重增加情况,计算孕前体重指数,并随访妊高征、巨大儿和低体重儿的发生情况。结果(1)孕前肥胖孕妇妊高征和巨大儿的发生率明显高于孕前消瘦和理想体重的孕妇(P<0.01和P<0.05),而后两组间无差别(P>0.05);孕前消瘦孕妇低体重儿的发生率明显高于孕前理想体重和肥胖的孕妇(P<0.01),而后两组间无差别(P>0.05)。(2)无论孕前体重指数如何,当孕期体重增加≥18kg时妊高征和巨大儿的发生率明显增高(P<0.01),而当孕期体重增加<9kg时低体重儿的发生率明显增高(P<0.01)。(3)对孕前消瘦和理想体重的孕妇,孕期体重增加≥18kg时,妊高征的发病率明显增高,而对孕前肥胖的孕妇,孕期体重增加≥9kg时,妊高征的发病率明显增高(P<0.05);孕前理想体重孕妇孕期体重增加≥18kg时巨大儿的发病率明显增高(P<0.01),孕前消瘦和肥胖的孕妇随孕期体重的增加巨大儿的发病率也增加,但无统计学意义;对孕前消瘦和理想体重的孕妇孕期体重增加<9kg时,低体重儿的发病率明显增高(P<0.01)。结论孕前体重指数和孕期增重是妊高征及新生儿出生体重的重要影响因素。

Objective To determine the influence of pre-pregnant body mass index (BMI) and weight gain during pregnancy on the occurrence of pregnancy-induced hypertension (PIH) and birth weight. Methods Pre-pregnant BMI and pregnancy weight gain of 769 mothers giving full-term birth to a single baby for the first time were measured and the pregnancy outcomes were followed up. Results (1) The incidence of PIH and fetal macrosomia was significantly higher in the overweight group than in the normal weight and underweight groups (P<0.01 and P<0.05, respectively), but differed little between the latter two groups (P>0.05). Underweight mothers were more likely to give birth to babies with low birth weight than the normal and overweight mothers (P<0.01), but the likelihood was similar between the latter two groups (P>0.05). (2) Irrespective of the pre-pregnant BMI, PIH and fetal macrosomia occurred at higher rates with the mothers with pregnancy weight gain no less than 18 kg (P<0.01), whereas low birth weight was significantly more likely with mothers with pregnancy weight gain less than 9 kg (P<0.01). (3) A weight gain during pregnancy over 18 kg gave rise to higher risk of PIH in normal and underweight mothers, but in overweight group, PIH occurred at a significantly higher rates when a weight gain more than 9 kg was recorded (P<0.05). The incidence of fetal macrosomia was significantly higher when the maternal weight gain exceeded 18 kg in the normal weight group (P<0.01), and low birth weight occurred more frequently in relation to a maternal weight gain less than 9 kg in the normal and underweight groups (P<0.01). Conclusion Pre-pregnant BMI and weight gain during pregnancy can be important factors influencing the occurrence of PIH and the neonates' birth weight.