孕前肥胖与妊娠不良结局的相关性探讨

Effect of pre-pregnancy body mass index on adverse pregnancy outcomes

目的探讨孕前肥胖与妊娠不良结局的相关性。方法选取单胎、足月、无妊娠合并症及并发症的498例初产妇作为研究对象,根据孕前体质量指数(BMI)不同分为4组:低体重组(BMI<18.5 kg/m2)、正常体质量组(18.5kg/m2≤BMI<23.9 kg/m2)、超重组(24 kg/m2≤BMI<27.9 kg/m2)和肥胖组(BMI≥28 kg/m2)。比较四组孕妇一般资料和分娩结局情况。结果超重组和肥胖组体重增加明显低于正常体质量组和对照组,组间比较差异有明显统计学意义(P<0.05);超重组和肥胖组大学以上学历孕妇所占比率明显低于正常体质量组、低体重组(P<0.05)。低体重组与正常体质量组各项妊娠结局未发现明显的差异,差异无具有统计学意义(P>0.05),而超重组和肥胖组的子痫前期、妊娠期糖尿病、妊娠高血压、胎膜早破、产后出血、剖宫产、新生儿死亡和巨大胎儿的发生率均明显高于对照组和正常体质量组,组间比较差异具有统计学意义(P<0.05)。结论孕前超重和肥胖对妊娠不良结局具有相关性,临床应特别重视对文化程度低的孕妇进行体重控制管理。通过对孕前体质量的控制,可以有效地改善妊娠结局,保证母婴健康。

Objective To discuss the correlation of pre- pregnancy obesity and poor pregnancy outcomes. Methods According to pre-pregnancy body mass index（ BMI）,498 cases of pregnant women were divided into four groups： low- weight group（ BMI 〈18. 5 kg / m^2）,normal weight group（ 18. 5 kg / m^2≤BMI 〈23. 9 kg/m^2）,overweight（ 24 kg/m^2≤BMI〈 27. 9 kg/m^2） and obese group（ BMI≥28 kg/m^2）. General information on the situation and outcomes of delivery were compared in four groups of pregnant women. Results Overweight and obese weight gain was significantly lower than the normal weight group,low- weight group,the difference between the two groups statistically significant（ P〈0. 05）. Overweight and obesity percentage was significantly lower than normal pregnant women body weight group,low- weight group（ P 〈0.05）. Low body mass and normal body weight group,the pregnancy outcome found no significant differences,the difference was not statistically significant（ P〉0. 05）. While in the overweight and obese groups,preeclampsia,gestational diabetes,pregnancy- induced hypertension,premature rupture of membranes,postpartum hemorrhage,cesarean section,macrosomia and neonatal death was significantly higher than the incidence of low- weight group,normal weight group,the difference between the groups was statistically significant（ P〈0. 05）. Conclusion Overweight and obesity before pregnancy has an adverse effect on pregnancy outcome,we should pay particular attention to the low level of education of pregnant women weight control management. By pre- pregnancy body mass index of control,can effectively improve pregnancy outcomes,ensure maternal and child health.