孕前体重指数和孕期增重速度对妊娠结局的影响

Effect of prepregnancy body mass index and weight gain during pregnancy on pregnancy outcome

目的探究孕前不同体重指数和孕期体重增长速度对妊娠结局的影响。方法选取该院2014年1月-2016年8月接收的孕产妇4 000例为研究对象,根据孕产妇的孕前体重指数分为肥胖组(309例)、超重组(459例)、正常组(2 518例)和消瘦组(651例),对比4组孕产妇在孕期体重增长情况及妊娠结局。根据孕产妇孕期体重增长情况又分为孕期体重过轻组(961例)、孕期体重正常组(1 369例)和孕期体重过重组(1 670例),比较3组孕产妇在孕期体重增长情况及对妊娠结局的影响。结果 4组孕妇中出现妊娠高血压、妊娠期糖尿病、产后贫血、剖宫产率、新生儿出生体重和巨大儿发生率等差异有统计学意义(P<0.05),而产后出血情况比较差异无统计学意义(P>0.05);孕期3组孕妇中出现妊娠高血压、妊娠期糖尿病、产后贫血、剖宫产率、新生儿的体重和巨大儿发生率等差异有统计学意义(P<0.05),而产后出血情况比较差异无统计学意义(P>0.05)。结论孕前体重指数过高和孕期体重增长过快不仅会增加孕产妇妊娠期并发症的发生率,还会增加产后贫血的发生几率,新生儿的出生体重和巨大儿的发生率也会有所增加。产科医护人员应加强对孕前体重指数过高的孕产妇护理,使孕产妇体重增长控制在合理的范围内,以此保证孕产妇妊娠期的身体质量,减少母婴并发症。

Objective To explore the effect of different prepregnancy body mass indexes（BMI） and weight gains during pregnancy on pregnancy outcome.Methods A total of 4 000 pregnant women were selected from the hospital from January 2014 to August 2016 as study object,then they were divided into obesity group（309 women）,overweight group（459 women）,normal weight group（2 518 women）,and thin group（651 women） according to prepregnancy BMI.Weight gains during pregnancy and pregnancy outcomes in the four groups were compared.All the pregnant women were divided into pregnancy underweight group（961 women）,pregnancy normal weight group（1 369 women）,and pregnancy overweight group（1 670 women） according to weight gain during pregnancy.The effect of weight gain during pregnancy on pregnancy outcome in the three groups were compared.Results There were statistically significant differences in the incidence rates of hypertensive disorder complicating pregnancy,gestational diabetes mellitus,postpartum anemia,cesarean section,neonatal birth weight,and macrosomia among obesity group,overweight group,normal weight group,and thin group（P〈0.05）,but there was no statistically significant difference in the incidence rate of postpartum hemorrhage（P〈0.05）.There were statistically significant differences in the incidence rates of hypertensive disorder complicating pregnancy,gestational diabetes mellitus,postpartum anemia,cesarean section,neonatal birth weight,and macrosomia among pregnancy underweight group,pregnancy normal weight group,and pregnancy overweight group（P〈0.05）,but there was no statistically significant difference in the incidence rate of postpartum hemorrhage（P〉 0.05） among the three groups.Conclusion High pre-pregnancy BMI and weight gain during pregnancy will not only increase the incidence rate of pregnancy complications,but also increase the incidence rate of postpartum anemia.Neonatal birth weight and the incidence rate of macrosomia also increase.The obstetricians and nurses should strengthen maternal health care with high pre-pregnancy BMI to control weight gain during pregnancy within reasonable range,so maternal body quality during pregnancy can be ensured,and maternal and infantile complications can be reduced.