孕前体重指数及孕期体重增加对围产结局的影响

Influence of perinatal outcomes of pre-pregnancy body mass index and body mass gain during pregnancy

目的探讨孕前体重指数与孕期体重增幅对围产结局的影响。方法对2011年8月～2012年7月在我科住院分娩的产妇1628例,按孕前体重指数分为低体重组(BMI<18.5)、体重正常组(18.5≤BMI≤23.5)、超重组(BMI>23.5);根据不同孕前体重指数孕期应正常增加的体重分为体重增加过低组、体重增加正常组、体重增加过多组,比较分析各组间围产结局的差异。结果超重组产后出血、子痫前期、新生儿窒息、巨大儿发生率高于体重正常组和低体重组;低体重组早产发生率低于体重正常组和超重组;低体重组FGR的发生率高于体重正常组和超重组,差异均有统计学意义(P<0.01)。体重增加过低组早产、FGR发生率高于体重增加正常组和体重增加过多组;而巨大儿的发生率低于体重增加正常组和体重增加过多组;体重增加过多组子痫前期发生率高于体重增加正常组和体重增加过低组,差异均有统计学意义(P<0.01)。结论孕前肥胖及孕期体重增加过多或过少均可引起不良妊娠结局。

Objective To investigate the influence of maternal pre-pregnancy body mass index （BMI） and body mass gain during pregnancy on obstetric outcomes. Methods This study was register-based prospective cohort study. 1 628 preg- nancy women in our hospital between Aug 2011 and Jul 2012 were enrolled. Perinatal outcomes were observed and analyzed ac- cording to maternal pre-pregnancy body mass index （BMI） categories lower weight group（BMI〈18.5 ）, normal weight group （18.5≤ BMI ≤23.5）, over weight group （BMI〉23.5）, and according to weight gain during pregnancy categories： lower weight gain group, normal weight gain group,over weight gain group. Results The rate of postpartum hemorrhage,preeclampsia,asphyxia neonatorum, fetal macrosomia in over weight group was the highest of other two groups; the rate of premature delivery in lower weight group was the lowest of other groups （P〈0.01）. The rate of premature delivery,FGR in lower weight gain group was the hightest of other two groups; the rate of fetal macrosomia in lower weight gain group was the lowest of other groups ; the rate of preeclampsia in over weight gain group was the hightest of other two groups. Conclusion Pro-pregnancy body mass index and the number of mass gain during pregnancy should be suitably controlled, and then the prenatal outcome would be enhanced.