分娩巨大儿孕妇孕中期母体体成分分析

Analysis of maternal body composition in the second trimester of pregnant women with fetal macrosomia as pregnant outcome

目的将巨大儿孕妇孕中期母体体成分与正常孕妇比较,分析之间的异同。方法选择在南京大学医学院附属鼓楼医院建卡并分娩单胎巨大儿的孕妇64例,并选取同时期建卡、足月分娩的单胎健康孕妇268例,回顾性分析这些孕妇在孕中期20至27^(+6)周母体体成分的异同。结果分娩巨大儿孕妇组身高、孕前体重、BMI、检查时体重、体重增长、年龄和生产孕周均高于正常组(F值分别为0.005、2.137、5.642、1.296、1.725、4.924、0.473,均P<0.05);在母体成分方面,细胞外液、细胞内液、水分含量、蛋白质、矿物质、骨骼肌肉量、去脂体重、体脂肪和内脏脂肪比例,分娩巨大儿孕妇组均明显高于正常组(F值分别为0.041、0.065、0.013、0.060、0.132、0.031、0.034、5.044、0.467,均P<0.01);而水分百分比、蛋白质百分比和矿物质百分比,分娩巨大儿孕妇低于正常组(F值分别为1.541、0.357、8.128,均P<0.01)。结论分娩巨大儿的孕妇在孕中期的体成分组分异于正常组,孕期的体重增长可能是一种体脂和去脂体重比例不合理的增长模式,这也许是导致巨大儿发生的原因之一。

Objective To analyze the differences in maternal body composition during the second trimester between healthy pregnant women and those with fetal macrosomia as pregnant outcome. Methods Sixty-four cases of pregnant women who opened accounts and delivered a single-fetus fetal macrosomia at Affiliated Gulou Hospital of Nanjing University Medical School were chosen as the study group and 268 healthy pregnant women who opened accounts at the same period and gave birth to full-term single-fetus healthy baby were chosen as control group. A retrospective analysis was conducted to study the difference in maternal body composition between those women during their second trimester, namely from 20 to 27 ＋6 gestational week. Results Indexes of height, pre-pregnancy body mass, BMI, body weight over examination, weight increasing, age and gestational weeks were higher in women with fetal maerosomia as pregnant outcome compared with those in healthy pregnant women （F value was 0. 005, 2. 137, 5. 642, 1. 296, 1. 725, 4. 924 and 0. 473, respectively, all P 〈 0.05 ）. As for body compositions, indexes of extracellular fluid, intracellular fluid, moisture content, protein, minerals, skeletal muscles mass, fat free mass （FFM） , proportion of body fat and visceral fat were all remarkably higher in study group than those in the control group （F value was 0. 041, 0. 065, 0.013, 0. 060, 0. 132, 0. 031, 0. 034, 5. 044 and 0. 467, respectively, all P 〈 0.01 ）. However, the percentage of moisture, protein and minerals of the study group were lower than those of the control group （ F value was 1. 541, 0. 357 and 8. 128, respective/y, all P 〈0.01 ）. Conclusion There are differences in maternal body composition during the second trimester between pregnant women with fetal macrosomia as pregnant outcome and healthy pregnant women. Weight increasing of women in study group during pregnancy is likely to be an unreasonable growth mode with the proportion between body fat and FFM, which is probably one of the causes of delivering fetal macrosomia.