孕期妇女体质量管理与新生儿出生体重的关系

The relationship between body weight management during pregnancy and birth weight of newborns

目的了解孕期妇女增重程度及体质量管理对新生儿出生体重的影响。方法收集2009年1月至2011年12月期间，在西安市中心医院产前检查并分娩的单胎妊娠孕妇4811例，记录其孕早期身高、体重及孕期增重和新生儿出生体重，结合人体质量指数，将孕期增重程度分为增重不足、增重合适和增重过多，统计分析孕期增重与新生儿出生体重及低出生体重、巨大儿发生的关系。结果与孕期增重合适者相比，增重不足及增重过多者分娩低出生体重儿发生率均明显增加（t=24．10，P〈0．01；t=10．23，P〈0．01）；同时孕期增重过多者中最高，有统计学意义（t=14．84，P〈0．01）。孕期增重不足是低出生体重的危险因素（RR：2．32，95％CI：1．70～3．18），是巨大儿的保护因素（RR=0．48，95％C1：0．30～0．76），孕期增重过多同时是低出生体重（RR=2．06，95％CI：1．31—3．23）和巨大儿（RR=1．55，95％C1：1．27—1．89）的危险因素（均P〈0．05）。结论孕期妇女体质量管理是控制新生儿出生体重的重要措施之一。

Objective To understand the gestational weight gain and the influence of weight management on neonatal birth weight. Methods From January 2009 to December 2011 4 811 pregnant women with single pregnancy accepted prenatal examination and delivered in Hospital of Xi＇ an City. Their height at early pregnancy, maternal weight, gestational weight gain and neonatal birth weight were recorded. According to body mass index （BMI） gestational weight gain was grouped as less weight gain, appropriate weight gain and excessive weight gain. The relationship between gestational weight gain and neonatal birth weight, low birth weight （LBW） and macrosomia was analyzed. Results Compared with the cases with appropriate gestational weight gain, the incidence of LBW increased significantly in cases with less weight gain and those with excessive weight gain （t = 24.10 ,P 〈 0.01 ;t = 10.23 ,P 〈 0.01 ）. The incidence was highest in cases with excessive weight gain, and the difference was significant （ t = 14.84, P 〈 0.01 ）. Less weight gain was risk factor of LBW （RR =2.32,95%CI：1.70-3.18）, but it was protective factor of macrosomia （RR =0.48, 95% CI：O. 30-0.76）. Excessive weight gain was the risk factor of both LBW （RR =2.06, 95%CI：1.31-3.23） and macrosomia （RR =1.55, 95%CI：1.27-1.89） （both P〈O. 05）. Conclusion Management eC gestational weight is one of important measures to control neonatal birth weight.