妊娠中晚期增重速度与孕期总增重和新生儿出生体重的关系

Associations of maternal weight gain rate in mid-and late-pregnancy with total gestational weight gain and neonatal birth weight

目的探讨妊娠中晚期体重增长速度与孕期总增重和新生儿出生体重的关系。方法回顾性分析2011年8月至2012年2月在北京妇产医院进行常规产前检查和分娩的孕妇临床资料,记录年龄、分娩孕周、身高、孕前体重、分娩前体重、孕期体重监测数据、新生儿出生体重、性别等资料。对资料进行t检验、单因素方差分析、Spearman相关性分析和多元线性回归分析。结果孕妇妊娠中期增重速度[(0.68±0.26)kg/周]大于妊娠晚期增重速度[(0.52±0.25)kg/周],差异有统计学意义(P<0.01)。妊娠中期增重速度与孕期总增重(r=0.446,P<0.01)、新生儿出生体重(r=0.123,P<0.01)皆呈正相关;而妊娠晚期增重速度只与孕期总增重呈正相关(r=0.560,P<0.01),与新生儿出生体重则无显著相关性(r=-0.025,P>0.05);巨大儿组和正常体重儿组孕妇的孕前BMI[(22.3±2.9)kg/m^2 vs.(20.8±2.8)kg/m^2]、孕期总增重[(18.5±4.3)kg vs.(16.6±4.6)kg]和妊娠中期增重速度[(0.74±0.26)kg/周vs.(0.67±0.26)kg/周]相比,巨大儿组皆高于正常体重儿组,P值均<0.01;而2组的妊娠晚期增重则无明显差异(P>0.05)。结论不同孕期体重增长速度对新生儿出生体重的影响可能不同,妊娠中期增重速度对新生儿出生体重的影响大于妊娠晚期增重速度。

Objective To investigate the association of maternal weight gain rate in mid- and late-pregnancy with total gestational weight gain and neonatal birth weight. Methods This is a retrospective study. Women who had regular prenatal examinations and delivered in Beijing obstetrics and gynecology hospital from August 2011 to February 2012 were enrolled. Data including maternal age, height, pre-pregnancy weight, weight before delivery, weight measurements during pregnancy, gestational age, neonatal birth weight and sex were recorded. The analysis of variance, Student＇ s t test, Spearman correlation analysis and multiple linear regression analysis were used for statistical analysis. Results Women gained weight faster in mid-pregnancy （0.68±0.26 kg/week） than late-pregnancy （0.52±0.25 kg/week ）. The rate of weight gain in mid-pregnancy was positively correlated with total gestational weight gain（r = 0.446, P 〈 0.01） and neonatal birth weight（r = 0.123, P 〈 0.01）. The rate of weight gain in late-pregnancy was also positively correlated with total gestational weight gain（r = 0.560, P 〈 0.01）, but there was no strong evidence of association for the rate of weight gain in late-preg- nancy with neonatal birth weight（r=0.025, P 〉 0.05）. Women with macrosomic infants had higher pre-pregnant BMI, total gestational weight gain and rate of weight gain in mid-pregnancy compared with those with normal weight infants. Conclusion The effects of maternal weight gain rate on neonatal birth weight varies by trimester of pregnancy. These findings suggest that the rate of weight gain in mid-pregnancy may more strongly influence neonatal birth weight than the rate of weight gain in late-pregnancy.