孕早期体重过低及孕期体重增加对分娩结局的影响

Effect of women with underweight in early pregnancy stage and weight gain during pregnancy on delivery outcome

目的:探讨体重过低及孕期体重增加幅度对分娩结局的影响。方法:162例体重指数(BMI)<18.5的初产妇为体重过低组和377例BMI18.5～22.9的初产妇为标准体重组,进一步将体重过低组根据孕期体重增加幅度分为≥15kg和<15kg组,对比分析各组总产程时间、第一产程时间、产程异常率、剖宫产率、新生儿出生体重、早产率、新生儿窒息率。结果:体重过低组与标准体重组的产程时间、产程异常率、剖宫产率无统计学差异(P>0.05),体重过低组的早产率、新生儿窒息率显著高于标准体重组(P<0.05),新生儿出生平均体重低于标准体重组(P<0.05)。体重过低的初产妇孕期体重增加≥15kg其产程时间延长(P<0.01,P<0.05),产程异常率和剖宫产率高于<孕期体重增加15kg组(P<0.05),新生儿出生平均体重高于<孕期体重增加15kg组(P<0.05)。结论:①孕早期体重过低可能不增加异常产程的风险;②孕早期体重过低可影响新生儿出生体重,增加早产的风险;③体重过低的孕妇孕期体重增长过快可导致产程异常和手术产率增加。

Objective： To investigate the effect of women with underweight in early pregnancy stage and weight gain during pregnancy on delivery outcome. Methods： 162 primiparas with underweight （body mass index 〈 18. 5） and 377 primiparas with ideal weight （body mass index 18.5 - 22. 9） were selected in this study. The primiparas with underweight was further divided according to weight gain during pregnancy. The duration of labor, the incidences of abnormal labor, cesarean section, neonatal birth weight, the incidences of premature delivery and birth asphyxia were compared in both groups. Results： The duration of labor, the incidences of abnonual labor, cesarean section were not significant difference between in the underweight group and ideal weight group （ P 〉 0, 05 ） . But the incidences of premature delivery and birth asphyxia in underweight group were significant higher than in ideal group （ P 〈 0. 05） . The mean of neonatal birth weight in underweight group was significant lower than in ideal group （P 〈0. 05） . The duration of labor, the incidences of abnormal labor and cesarean section increased significantly when maternal weight gained ≥ 15 kg in the underweight group （ P 〈 0. 01, P 〈 0.05 ） . Moreover the mean of neonatal birth weight in weight gained t〉 15 kg group was higher than in weight gained 〈 15 kg group （P 〈 0. 05） . Conclusion： ①Women with underweight in early pregnancy stage would not increase the risk of abnormal labor. ②There are strong relationship between women with underweight in early pregnancy stage and the occurrence of prematnre delivery and the neonates＇hirth weight. ③Primiparas with underweight in early pregnancy stage when weight gain faster during pregnancy there will increase the incidences of abnormal labor and cesarean section.