孕前体质量指数及孕期增长与母婴结局的关系

Relationship between pre-pregnant body mass index and pregnancy growth with maternal and neonatal outcomes

目的探讨孕妇孕前体质量指数(BMI)及孕期BMI增长对母婴结局的影响。方法随机选取2011年度在重庆市东南医院(原西郊医院)建册、正规产检、住院分娩的孕妇250例,按孕前BMI分为3组(消瘦组、适宜组、肥胖组),比较各组的剖宫产、巨大儿、低体质量儿、产后出血、妊娠期糖尿病、妊娠期高血压、胎儿窘迫、新生儿窒息及产褥感染的发生率。另外,根据孕期BMI增幅(△BMI)的不同,将所有孕妇重新分为3组(不足组、适宜组、过多组),再比较各组不同的母婴结局。结果肥胖组的剖宫产率、巨大儿出生率、妊娠期糖尿病及妊娠期高血压的发生率均明显高于消瘦组、适宜组(P<0.05),消瘦组的低体质量儿发生率均明显高于适宜组、肥胖组(P<0.05);△BMI过多组的剖宫产率、巨大儿出生率、妊娠期糖尿病及妊娠期高血压疾病的出生率均明显高于不足组、适宜组(P<0.05),△BMI不足组的低体质量儿出生率明显高于适宜组、过多组(P<0.05)。结论孕前BMI超标及孕期BMI增长过多的孕妇,其母婴结局令人担忧。孕前BMI及孕期BMI增长的快慢和多少是监测母婴并发症的重要指标之一。

Objective To explore the effects of the pre-pregnant body mass index（BMI） and the pregnancy growth on the mater-nal and neonatal outcomes .Methods 250 pregnant women with the built file ,regular antenatal inspection and hospital delivery in our hospital during 2011 were selected and divided into the emaciation group ,the appropriate group and the obesity group according to the pre-pregnant BMI .The occurrence rates of cesarean section ,fetal macrosomia ,low birth weight ,postpartum hemorrhage ,ges-tational diabetes ,gestational hypertension disease ,fetal distress ,neonatal asphyxia and puerperal infection were compared among the various groups .In addition ,according to the different growth amplitudes of pregnancy BMI ,the pregnant women were re-divided in-to 3 groups（weight gain insufficient group ,weight gain appropriate group and weight gain overmuch group ） and the different ma-ternal and neonatal outcomes were compared .Results The occurrence rates of cesarean section ,macrosomia ,gestational diabetes and gestational hypertension disease in the obesity group were significantly higher than those in the emaciation group and the appro-priate group（P＆lt;0 .05） ,while the occurrence rate of the low birth weight in the emaciation group was significantly higher than that of the appropriate group and the obesity group（P＆lt;0 .05）;the occurrence rates of cesarean section ,macrosomia ,gestational diabetes and gestational hypertension disease in the weight gain overmuch group were significantly higher than those in the weight gain in-sufficient group and the weight gain appropriate group（P＆lt;0 .05） ,while the occurrence rate of low birth weight in the weight gain insufficient group was significantly higher than that of the weight gain appropriate group and the weight gain overmuch group （P＆lt;0 .05） .Conclusion The maternal and neonatal outcomes in the pregnant women with pre-pregnant BMI exceeding the standard and pregnant BMI overmuch growth are very worrying .The growth of pre-pregnant BMI and pregnant BMI is one of the important indi-cators for monitoring the maternal and neonatal complications .