初产妇早孕期增加的体质量指数对妊娠结局的影响

Influence of body mass index increase in nulliparous women on pregnancy outcome

目的探讨初产妇增加的体质量指数(BMI)与不良妊娠结局的关系。方法回顾性的分析2011年4～12月在镇江市妇幼保健院分娩的有记录的单胎初产妇资料,根据第1次产前检查(妊娠10～15周)记录的体质量、身高计算BMI,分为4组(体质量较轻组BMI≤18、正常体质量组BMI>18～24、过重体质量组BMI>24～28、肥胖组BMI>28),将其他3组的资料与正常体质量组资料相比较,分析早孕期BMI与妊娠结局的关系。结果随BMI增加剖宫产率升高;过重体质量组的延期妊娠、引产风险与正常组相比增加RR=2.2(CI=1.4～3.4)、RR=2.3(CI=1.4～3.8);与其余3组相比正常体质量组的早产率6.8%最低。肥胖组的巨大儿风险与正常BMI组比较增加2.7倍RR=2.7(95%CI=1.5～5.1),肥胖组的高危妊娠风险与正常体质量组相比增加2.1倍RR=2.1(CI=1.2～3.5)。结论增加的早孕期BMI与一些不良的妊娠结局相关。

Objective The aim of the study was to demonstrate the influence of increasing body mass index（BMI） in pregnancy on rates of adverse pregnancy outcome in nulliparous women.Methods The study was a retrospective review of data from Zhenjiang Maternal and Child Health Hospital.We reviewed all nulliparous women with recorded BMI at booking between April,2011 and December,2011 who delivered singleton babies.We got the BMI according to the patients’ height and mass at the first obstetrics visit（10-15 weeks）.All the women were stratified into four BMI groups（under mass BMI≤18,normal mass BMI〉18-24,over mass BMI〉24-28,obese BMI〉28）.The different BMI range groups were compared with the group of women with normal BMI.Results With increasing maternal BMI,the rate of caesarean section rose,over mass BMI group had high risks of the rate of post-dates and induction of labor compared with normal BMI group RR=2.2（CI=1.4-3.4）,RR=2.3（CI=1.4-3.8）.Compared with the other three groups,the normal BMI group had the lowest preterm delivery rate.Obese women had 2.7 times risk of fetal macrosomia compared with normal BMI women RR=2.7（CI=1.5-5.1）.The high risk pregnancy rate was associated with obese BMI group with RR=2.1（CI=1.2-3.5）.Conclusion Increasing BMI degrees at the first obstetrics visit are associated with increases in the incidence of some adverse pregnancy outcomes.