孕产妇参与孕期体重管理情况分析与有效措施

The participation of pregnan woment in pregnancy weight management and the effective measures

目的探讨对孕产妇进行体重管理的有效措施，及其对妊娠结局的影响。方法选取孕早期或孕前体重指数正常的单胎妊娠孕妇240例，随机抽取120例作为实验组，另外的作为对照组；对照组给予常规护理、培训和定期检查，实验组在对照组的基础上还进行体重干预，包括指导其进行合理控制饮食、适量运动、围产期基础知识培训等，观察分娩前后的体重指数变化，分析其有效措施并评价对妊娠结局的影响。结果实验组体重指数变化≥6（50．0％vs．76．7％）、妊高症（6．7％vs．15．8％）、糖尿病（2．5％vs．15．0％）、巨大儿（5．0％vs16．7％）、胎儿宫内窘迫（3．3％vs．12．5％）、产后出血（3．3％vs．13．3％）的发生率均小于对照组，差异均有显著性（P〈0．05）；实验组阴道分娩为55．0％，显著高于对照组的16．7％。结论孕产妇参与孕期体重管理，能有效降低妊娠期、分娩期并发症、剖宫产率、难产率等，能显著改善妊娠结局。

Objective To explore the effective measures for weight management in pregnant women and their influence on pregnancy outcomes. Methods 240 women with a singleton pregnancy who had a normal body mass index （ BMI ） before gastation or at the first trimester were randomly assigned to study group （ 120 women ）, or control group （ 120 women ）. Both group received conventional care, training and regular examination, and the study group received additional body weight intervention including reasonable dietary control, proper exercise, and basic perinatal education. Changes in BMI after labor were observed; the effective measures were analyzed and their influence on pregnancy outcomes was assessed. Results The incidence rates of BMI≥ 6, gestational hypertension, diabetes, vaginal delivery, fetal macrosomia, fetal distress, and postpartum hemorrhage was lower in the study group than in the control group （ X 2= 19.437, P 〈 0.01 ; x2 =4.899, P 〈 0.05 ）; X 2= 6.913, P 〈 0.01 ; X 2= 14.564, P 〈 0.001; X2=7.354, P〈 0.05; X2=4.637, P〈 0.05; and XZ=6.913, P〈 0.05）.Conclusions Partieipation of pregnant women in pregnancy weight management ean effectively reduce the eomplieations during pregnancy and delivery and the rates of Cesarean section and dystoeia, significantly improving pregnancy outcomes.