早孕期骨密度正常妇女产褥期骨密度分析

Bone mineral density analysis in puerperium women with normal bone mineral density in early pregnancy

目的分析早孕期骨密度正常妇女产褥期骨密度情况,分析产前、产时、产后各种因素对产褥期骨密度的影响。方法对210名在海淀妇幼保健院建档并住院分娩的早孕期桡骨骨密度正常的妇女在产褥期进行超声骨密度测定,分析孕前体重指数、孕期体重增长、分娩方式、胎儿体重、产后出血、产后喂养方式、产后补钙情况、产后户外活动等对产褥期骨密度的影响。结果早孕期骨密度正常的妇女在产褥期骨密度正常者占90.5%,骨量减少占9.5%,骨质疏松0%。210名妇女产褥期骨密度较早孕期减少,差异有统计学意义(P<0.05)。产后出血量多于500m L,孕期体重增加超过12.5kg,产后未补钙及产后户外活动少的产妇,产褥期骨密度较低,差异有统计学意义(P<0.05)。而孕前体重指数、分娩方式、胎儿体重、产后喂养方式对产褥期骨密度无影响(P>0.05)。结论产褥期骨密度较早孕期下降,孕期控制体重增长、产褥期补钙、适当户外活动,可减少骨量流失。

Objective To assess the bone mineral density（ BMD） in puerperium women with normal BMD in early pregnancy,and to analyze the effect of factors in antenatal,intrapartum,and postpartum on BMD in puerperium. Methods A total of 210 puerperium women with normal BMD in early pregnancy in Haidian Maternal and Child Health Hospital were documented and ultrasound bone densitometer was used to measure the BMD of the distal radius. The effect of body weight index（ BMI）,weight gain in gestation,delivery mode,fetus weight,postpartum hemorrhage,feeding pattern,postpartum calcium supplement,and outdoor activities in postpartum on puerperium BMD were analyzed. Results In all the women,normal BMD accounted for90. 5%,osteopenia and osteoporosis accounted for 9. 5% and 0%,respectively. BMD in puerperium was lower than that in early pregnancy,and the difference was statistically significant（ P 〈 0. 05）. The women with postpartum hemorrhage more than 500 m L,weight gain in gestation more than 12. 5kg,no postpartum calcium supplement,and less postpartum outdoor activities had lower BMD,and the difference was statistically significant（ P 〈 0. 05）. BMI,delivery mode,fetus weight,and feeding pattern had no effect on BMD in puerperium. Conclusion BMD in puerperium is lower than that in early pregnancy. Proper weight gain in gestation,postpartum calcium supplement,and postpartum outdoor activities reduce osteopenia.