妊娠期体重增长与新生儿出生体重相关性的回顾性分析

Relationship between gestational weight gain and neonatal birth weight

目的探讨妊娠期体重增长（GWG）与新生儿出生体重的关系。方法回顾性分析2014年4~10月在北京协和医院普通产科规律产检并分娩的709例单胎妊娠孕妇的临床资料,根据孕前体重指数（BMI）及不同GWG进行分组,采用χ2检验和Logistic多因素回归分析检验GWG与新生儿出生体重及妊娠结局的关系。结果 （1）709例孕妇妊娠期平均增重（13.92±4.56）kg,新生儿平均出生体重（3 306±456）g;孕前低体重孕妇与正常体重孕妇比较,巨大儿发生率（0vs.6.6%）显著减少（P〈0.05）,小于胎龄儿（SGA）发生率（16.7%vs.8.6%）则显著增多（P〈0.05）。（2）GWG过少（IGWG）组、体重适宜组和GWG过多（EGWG）组3组间比较,巨大儿发生率（1.8%vs.6.1%vs.10.5%）有显著性差异（P〈0.05）;IGWG组的SGA发生率（13.8%）显著高于其他两组（8.9%、4.8%）（P〈0.05）。（3）EGWG（OR=1.91,95%CI：1.01-3.61）、妊娠期糖尿病（GDM）（OR=2.74,95%CI：1.38-5.45）是巨大儿发生的危险因素,而高龄（OR=2.36,95%CI：1.24-4.51）、孕前低体重（OR=2.15,95%CI：1.04-4.46）是SGA发生的危险因素。结论 GWG与新生儿出生体重存在密切关系,EGWG与GDM是巨大儿发生的危险因数,高龄和孕前低体重则是SGA发生的危险因素。

Objective： To explore the relationship between gestational weight gain（GWG）and neonatal birth weight.Methods： The data of 709 pregnant women who received regular prenatal care and delivered in the Department of Obstetrics Gynecology,Peking Union Medicine College Hospital（PUMCH）from April to October 2014 were retrospectively analyzed.The patients were divided to several groups according to pre-pregnancy body mass index（BMI）and GWG.The chi-square test and Logistic multivariate regression analysis test were used to analyze the relationship among GWG,birth weight and pregnancy outcomes.Results： The average GWG of the 709 women was（13.92±4.56）kg,and the average birth weight of the neonates was（3 306±456）g.The incidences of macrosomia（0vs.6.6%）and small for gestational age babies（SGA）（16.7% vs.8.6%）in the low-weight and normal weight before pregnancy groups were significantly different（P〈0.05）.The incidences of macrosomia（1.8% vs.6.1% vs.10.5%）during thelow GWG（IGWG）,normal weight,and high GWG（EGWG）groups were also significantly different（P〈0.05）,and the incidence of SGA in IGWG group（13.8%）was significantly higher than that of the other two groups（8.9%,4.8%）（P〈0.05）.Binary logistic regression showed that EGWG（OR=1.91,95%CI：1.01-3.61）and gestational diabetes（GDM）（OR=2.74,95%CI：1.38-5.45）were the risk factors for macrosomia;while advanced maternal age（OR=2.36,95%CI：1.24-4.51）and low pre-pregnancy weight（OR=2.15,95%CI：1.04-4.46）were the risk factors for SGA.Conclusions： The birth weight is closely related with GWG.EGWG and GDM are the risk factors for macrosomia,and the advanced maternal age and low pre-pregnancy weight are the risk factors for SGA.