孕妇体质指数增幅与妊娠结局的关系

Research of the relationship between pregnant women body mass index growth and pregnancy outcome

目的探讨孕前体质指数(BMI)及孕期BMI增幅与妊娠结局的关系。方法选择2012年1月至2014年1月于本院产科就诊的单胎初产妇3111例为研究对象。根据孕前BMI将其分为A组(正常,2115例),B组(超重,678例)、C组(肥胖,318例)。根据孕期BMI增幅将其分为D组(898例)、E组(1712例)、F组(501例)。观察并比较孕前BMI及孕期BMI增幅与妊娠结局、分娩方式的关系。结果 B组与C组妊娠高血压、妊娠糖尿病、胎儿窘迫、产后出血、巨大儿、早产发生率均明显高于A组(P<0.05)。E组与F组妊娠高血压、妊娠糖尿病、胎儿窘迫、产后出血、巨大儿、早产发生率比较差异均具有显著性(P<0.05),E组和D组仅早产发生率比较差异具有显著性(P<0.05)。B组和C组剖宫产率高于A组(P<0.05),C组顺产率低于A组和B组(P<0.05);F组剖宫产率高于E组与D组(P<0.05),顺产率低于E组与D组(P<0.05)。结论孕期BMI增幅与妊娠结局和剖宫产率相关,采取有效措施控制孕期BMI并指导产前胎儿体重预测,选择适合的分娩方式,避免母婴损害。

Objective To study the relation between pregnant women body mass index（BMI） growth and pregnancy outcome.Method From January 2012 to January 2014,3111 primipara of single fetus in our hospital were selected as the research objects.According to the pre-pregnancy BMI,they were divided into group A with 2115 cases（normal）,group B with 678 cases（overweight） and group C with 318 cases（obesity）.According to the pregnancy BMI growth,they were divided into group D with 898 cases,group E with 1712 cases,and group F with 501 cases.Observed and compared the relationship between pre-pregnancy BMI and pregnancy BMI growth with pregnancy outcome,delivery mode.Result The incidence of gestational hypertension,gestational diabetes mellitus,fetal distress,postpartum hemorrhage,macrosomia,premature delivery in group B and group C were significantly higher than group A（P〈0.05）.The incidence of gestational hypertension,gestational diabetes mellitus,fetal distress,postpartum hemorrhage,macrosomia,premature delivery between group E and group F were significant different（P〈0.05）.There was significant difference in the incidence of premature delivery between group E and group D（P〈0.05）.The cesarean section rate of group B and group C were higher than group A（P〈0.05）.The spontaneous delivery rate of group C was lower than group B and group A（P〈0.05）.The cesarean section rate of group F was higher than group E and group D,and the spontaneous delivery rate was lower than group E and group D（P〈0.05）.Conclusion Pregnant women weight growth is correlated with pregnancy outcome and the rate of cesarean section.Take effective measures to control trimester of pregnancy BMI and guide the antenatal fetal weight prediction,a good choice for the mode of delivery,maternal damage might avoidance.