孕前体质指数和孕期增重与妊娠期高血压疾病的关系

Relationship between BMI before pregnancy,body weight gain during pregnancy and hypertensive disorder complicating pregnancy

目的:探讨孕妇孕前体质指数(BMI)及孕期增重与妊娠期高血压疾病的关系。方法:采用统一设计的问卷,由调查员在分娩期间对孕妇进行面对面问卷调查,收集一般人口学特征、既往妊娠情况和疾病史等资料。结果:共调查3 293名孕妇,其中发生妊娠期高血压疾病388例(11.8%),子痫前期277例(8.4%)。不同的年龄、文化程度、孕产史、人均收入、居住地的孕妇发生妊娠期高血压疾病和子痫前期的比例比较,差异均有统计学意义(χ2=18.366、130.800、8.209、79.322、94.419,P均<0.05)。多因素Logistic回归分析显示,孕前BMI<18.5是妊娠期高血压疾病的独立保护因素,孕前BMI>24.0和孕期增重过多是发生妊娠期高血压疾病和子痫前期的独立危险因素。结论:孕前BMI>24.0和孕期增重过多均是发生妊娠期高血压疾病和子痫前期的危险因素,而孕前BMI<18.5是妊娠期高血压疾病的保护因素,应关注孕前BMI值和孕期体重变化,从而减少妊娠期高血压疾病的发生。

Objective： To explore the relationship between body mass index（ BMI） before pregnancy,body weight gain during pregnancy and hypertensive disorder complicating pregnancy（ HDCP）. Methods： A self-designed uniform questionnaire was used to conduct face-to-face investigation among pregnant women,the general demographic characteristics,history of pregnancy and history of diseases were collected. Results： A total of 3 293 pregnant women were surveyed,including 388 cases（ 11. 8%） with HDCP and 277 cases（ 8. 4%） with preeclampsia. There were statistically significant differences in the proportions of cases with HDCP and preeclampsia among cases with different ages,educational levels,history of pregnancy,per capita income and place of residence（ χ2= 18. 366,P 0. 05; χ2=130. 800,P 0. 05; χ2= 8. 209,P 0. 05; χ2= 79. 322,P 0. 05; χ2= 94. 419,P 0. 05）. Multivariate logistic regression analysis showed that BMI before pregnancy 18. 5 was an independent protective factor of HDCP,BMI before pregnancy 24. 0 and excessive body weight gain during pregnancy were independent risk factors of HDCP and preeclampsia. Conclusion： BMI before pregnancy 24. 0 and excessive body weight gain during pregnancy are risk factors of HDCP and preeclampsia,while BMI before pregnancy 18. 5 is an independent protective factor of HDCP; more attention should be paid to changes of BMI before pregnancy and body weight during pregnancy to reduce the occurrence of HDCP.