孕期体质量变化与分娩巨大儿的相关性研究

The relationship between the pregnancy weight changes and the delivery of fetal macrosomia

目的分析孕期体质量变化与巨大儿、分娩方式、新生儿疾病发生率的相关性。方法回顾性分析2011年1月—2014年12月住院分娩产妇140例,其中分娩新生儿体质量≥4 000 g产妇68例为巨大胎儿组,分娩新生儿体质量2 500~〈4 000 g孕妇72例为正常胎儿组,比较巨大胎儿组与正常胎儿组孕妇的孕前BMI及孕早、孕中、晚孕期体质量的增长速度（kg/周）,研究孕妇体质量变化与巨大儿的相关性,同时比较分娩方式及新生儿疾病发生率的差异。结果 2组孕妇的年龄比较差异无统计学意义（P〉0.05）;巨大胎儿组平均孕次、身高、产前体质量、孕前BMI及孕周均大于正常胎儿组,差异有统计学意义（P〈0.05）。巨大胎儿组的孕中期及孕晚期体质量增加速度、产前体质量、产前腹围及孕前BMI均大于正常胎儿组（P〈0.05）;2组孕期体质量增加速度均以孕中期为主,孕中期〉孕晚期〉孕早期,差异均有统计学意义（P〈0.05）;巨大胎儿组中剖宫产率和头盆不称、胎儿窘迫、胎膜早破、产后出血及新生儿窒息发生率明显高于正常胎儿组（P〈0.05）。结论孕期体质量增加值与巨大儿的发生有密切关系,孕妇可通过控制孕期体质量来减少巨大儿的发生。

Objective To analyze the relationship between body mass change during pregnancy and the occurrence rate of huge infant, delivery mode and neonatal disease. Methods A retrospective analysis of 140 eases of hospitalized pregnant women from January 2011 to December 2014 were performed. Among them, quality delivery of newborns is equal to or more than 4 000 g＇ s pregnant women of 68 cases were fetal macrosomia group, neonatal birth weight from 2 500 to 4 000 g＇ s pregnant women of 72 cases were normal fetus group, compared fetal macrosomia group and normal fetus group pregnant women＇ s pre-pregnancy BMI and early pregnancy, pregnancy and late pregnancy＇ s body mass growth rate （kg/week）, investigated maternal body weight change and fetal maerosomia＇ s correlation. At the same time, compared differences in the rate of mode of delivery and neonatal diseases. Results Difference of pregnant women＇s age between the two groups showed no statistical significance （ P 〉 0.05 ） ; fetal maerosomia group＇ s average pregnancy times, height, prenatal body mass, pre-pregnancy BMI and gestational weeks were higher than normal fetus group, the difference was statistically significant （ P 〈 0.05 ）. Fetal macrosomia group＇ s second trimester and late pregnancy＇ s body mass increased speed, prenatal body mass, prenatal abdominal circumference and BMI were higher than normal fetus group （ P 〈 0. 05 ） ; second trimester was the most fast increase of pregnancy body mass increased speed in both of the 2 groups, second trimester 〉 third trimester 〉 early pregnant, the differences were statistically significant （ P 〈 0. 05 ） ; fetal maerosomia group＇ s cesarean section rate and eephalopelvic, fetal distress, premature rupture of membranes, postpartum hemorrhage and neonatal asphyxia were significantly higher than that in normal fetuses （ P 〈 0.05 ）. Conclusion There is a close relationship between the body weight and the occurrence of the fetal macrosomia.