孕妇孕期增重对妊娠及妊娠结局的影响

Influence of pregnant women′s gestational weight gain on pregnancy and pregnancy outcomes

目的分析孕妇孕期增重对妊娠及妊娠结局的影响。方法采用随机抽样法抽取2013年10月~2014年10月在福州市台江区社区卫生服务中心围产保健科建档并定期行产前检查、孕前体质量指数（BMI）均在正常范围内的526名孕妇作为研究对象,根据孕期平均增重情况分为增重较低的A组（每周增重〈0.3 kg）、增重适中的B组（每周增重0.3~0.6 kg）、增重过度的C组（每周增重〉0.6 kg）,随访调查并分析孕妇孕期增重对妊娠及妊娠结局的影响。结果 A组孕妇妊娠期贫血、胎儿宫内生长受限及低体重儿发生率明显高于B组及C组,C组孕妇发生妊娠期贫血的概率又明显高于B组;C组孕妇发生妊娠期高血压疾病、妊娠期糖尿病、早产及分娩期手术产、产后出血的概率明显高于A组和B组,并且A组明显高于B组;A组孕妇因胎儿宫内窘迫而行剖宫产发生率与C组相近,但两组明显高于B组;C组新生儿出生体重明显高于另外两组;A组与C组的高危新生儿发生率相近,但两组的高危新生儿发生率明显高于B组。结论孕期增重不足或过度均会对母婴健康、妊娠及妊娠结局造成一定影响,会增加妊娠期并发症、早产、胎儿宫内窘迫致剖宫产、产后出血的发生率以及新生儿的危险,妊娠期间控制增重在每周增重0.3~0.6 kg有助于改善妊娠结局。

Objective To explore the influence of pregnant women′ s gestational weight gain on the pregnancy and pregnancy outcomes. Methods 526 pregnant women who established records and received regular prenatal examination in the Perinatal Care Department of Taijiang District Community Health Service Center in Fuzhou from October 2013 to October 2014 and whose body mass indices（BMI） were within the normal range were selected as the study subjects using the random sampling method.The patients were divided into group A with low weight gain（0.3 kg/week）,group B with moderate weight gain（0.3-0.6 kg/week） and group C with excessive weight gain（0.6 kg/week） according to the average gestational weight gain situation.Follow-up investigation of the influence of pregnant women′ s gestational weight gain on the pregnancy and pregnancy outcomes was conducted. Results Group A was significantly higher than group B and group C in the incidences of gestational anemia,fetal growth restriction and low-birth weight infants,and group C was significantly higher than group B in the probability of gestational anemia.Group C was significantly higher than the other two groups in the probabilities of gestational hypertension,gestational diabetes,premature labor,childbirth operative labor and postpartum hemorrhage,and group A was significantly higher than group B.Group A was similar to group C in the incidence of fetal distress induced cesarean section,but the two groups were significantly than group B.Group C was significantly higher than the other two groups in the neonate birth weight.Group A was similar to group C in the incidence of high risk neonates,but the two groups were significantly higher than group B. Conclusion Both insufficient and excessive gestational weight gain had certain influence on the maternal and child health,pregnancy and pregnancy outcomes,and can increase the incidences of gestational complications,premature labor,fetal distress induced cesarean section and postpartum hemorrhage and the neonate risk.Maintaining gestational weight gain between 0.3-0.6 kg/week is conducive to improving the pregnancy outcomes.