不同的孕期体重管理模式对妊娠结局影响的临床研究

Clinical study on effect between maternal pre-pregnancy body mass index,pregnancy weight gain and pregnancy results

目的:分析不同体重管理模式对妊娠结局的影响,为孕期保健提供依据。方法:对2009年3月以来门诊就医的1640例孕妇分为按体重增幅管理组716例(A组)和按体重指数管理组924组(B组),前瞻性研究两组体重管理模式对妊娠结局的影响。结果:两组孕妇在年龄、孕前体重、孕次、身高及产检次数上差异均无统计学意义(P>0.05)。两组早产发生率A组为10.20%,B组为6.49%,差异有统计学意义(P<0.01);足月低体重儿A组为4.61%,B组发生率为1.30%,差异有统计学意义(P<0.05);糖代谢异常率A组为17.32%,B组为13.10%,差异有统计学意义(P<0.01);两组巨大儿发生率A组为5.59%,B组为3.90%,差异有统计学意义(P<0.05);两组产后抑郁症A组为9.22%,B组为5.19%,差异有统计学意义(P<0.01);两组妊娠期高血压疾病、产后出血发生率的差异均无统计学意义(P>0.05)。结论:与按体重增幅管理相比,按体重指数管理可以减少早产、足月低体重儿、巨大儿、糖代谢异常和产后抑郁的发生。

Objective：To analyse the effects of different pattern of management of gestational weight on pregnancy outcomes.Methods：One thousand six hundred and forty pregnant women who had antenatal care in Changchun Gynecological and Obstetric Hospital were enrolled in the study and were divided into two groups based on their participating in different management of gestational management by prepregnancy body mass index（Group B）,weight management by amplitude（Group A）.The pregnancy outcomes of the two groups were prospectively studied..Results：716 patients in Group A and 924 patients in Group B achieved the ideal gestational weight gain respectively without significant maternal age,gravidity,parity,height and prepregnant weight.The incidence of low birth weight was 1.82% in the group A of management of gestational weight by body mass index and 0.54% in the group B of management of gestational weight by amplitude（P0.05）..And also,between the two groups there were significant differences in the incidence of early birth（10.61% in Group A and 6.49% in Group B） and the incidence of gestational glucose intolerance（17.31%in Group A vs 13.09 % in Group B）（P0.01）.However,the incidence of macrosomia,hypertensive disorder complicating pregnancy,cesarean section,congenital anomalies and postpartum hemorrhage between the two groups had no significances（P0.05）..Conclusion：Comparing to the gestational weight management by amplitude,the management by body mass index can decrease the incidence of preterm birth,mature low birth weight and gestational glucose intolerance..