孕妇体质指数(BMI)与早产类型的关系

Relationship between Body Mass Index(BMI)of Pregnant Women and the Type of Preterm Birth

目的：探讨妇女不同的孕前体质指数（BMI），及孕期BMI变化和早产类型的关系。方法：选择2003年1月至2005年1月间在我院产科住院分娩的1882例单胎产妇，测量其孕前身高、体重和终止妊娠前最后一次体重，计算孕前BMI及孕期BMI增加。按孕前BMI分为A组（BMI〈16．75kg／m^2）；B组（BMI在16．75。23．71kg／m^2）；C组（BMI〉23．71kg／m^2）三组，并随访其妊娠结局。按分娩孕周分为足月产、早期早产（〈32周）和轻型早产（PTB≥32周）三组。分组分析不同孕前BMI、孕期BMI变化与早产不同类型的关系。结果：三组中早期早产孕妇孕前BMI及孕期BMI增加均小于其它两组，差异有显著性（P〈0．01），A组早期和轻型早产的孕妇孕期BMI增加小于足月孕妇，有显著性差异（P〈0．05）。B组和C组早产与足月孕妇相比孕期BMI增加无显著性差异（P〉0．05）。早期早产组新生儿的身长、体重低于其它两组，其新生儿的窒息率明显高于其它组，差异有显著性（P〈0．01）。结论：孕妇的孕前BMI及孕期BMI变化对新生儿的体重、身长及预后有重要的影响。孕前低BMI与孕期低BMI增加与早产的危险性增加相关，尤其以早期早产更明显。

Objective： To study the relationship among pre- pregnancy body mass index （BMI）, gestational weight gain, change of BMI in gestational period and types of preterm birth. Methods： The data of 1882 cases of single preterm and term birth women was collected. The outcome of those women was followed up, the height, pre- pregnancy weight and the last weight before delivery were measured, and then BMI and BMI gain during pregnancy were calculated. According to pre- pregnancy BMI and delivery gestational weeks, all cases were divided into three groups： group A （BMI 〈 16.75kg/m^2）; group B （BMI16.75 - 23.71kg/m^2） and group C （BMI 〉 23.71kg/m^2） and three sorts： term birth and early preterm birth; and mild preterm birth, and respectively. Relationship between different groups of BMI and preterm birth were analyzed. Results： Compared with term birth and mild preterm birth, change of BMI during pregnancy with early preterm birth was significantly low in the three groups. Compared with term birth, change of BMI with mild preterm birth and early preterm birth was lower in group A, but no significant change in B and C groups. Conclusion： The pre - pregnancy under BMI and low BMI gain were related to preterm birth, especially to early preterm birth.