2013—2017年北京市通州区孕妇孕期增重状况及其影响因素

Gestational weight gain and risk factors in Tongzhou District, Beijing, 2013-2017

目的描述2013—2017年北京市通州区孕妇孕期增重状况,并分析其影响因素。方法基于北京市通州区妇幼保健院的电子信息系统,构建15 581名在通州区建立围产档案、进行产前检查并分娩的单胎妊娠活产且无合并症/并发症孕妇的回顾性队列,提取电子信息系统中孕妇一般人口学、既往孕产史、身体测量和产前检查信息。根据2009年美国医学研究所标准分为孕期增重过少、适宜和过多三组,比较不同特征孕妇的孕期增重情况,采用多分类Logistic回归分析发生孕期增重过少、过多的影响因素。结果研究对象的平均孕期总增重为(15.6±5.2)kg。孕期增重过少、适宜和过多的孕妇分别为14.7%、35.7%和49.6%。孕前超重/肥胖、初产、有剖宫产史、有巨大儿分娩史或春夏季受孕为孕期增重过多的危险因素,而文化程度为小学及以下为孕期增重过少的危险因素。结论孕妇孕前营养状况、孕产史、文化程度、怀孕季节和分娩年份对孕期增重有影响,应针对孕期增重过少/过多的危险因素制定合理的孕期体重管理措施。

Objective To describe the gestational weight gain (GWG) among pregnant women in Tongzhou District of Beijing from 2013 to 2017 and to analyze the risk factors. Methods Based on the electronic information system of Tongzhou Maternal and Child Health Hospital in Beijing, a retrospective cohort of 15 581 pregnant women with single pregnancy and live birth without complications was constructed. Information of demography, past pregnancy and childbirth history, physical measurement and prenatal examination information of pregnant women in the electronic information system were extracted. According to the standards of Institute of Medicine (IOM) in 2009, three groups were divided:inadequate GWG, appropriate GWG and excessive GWG. The weight gain of pregnant women with different characteristics was compared. The risk factors of inadequate GWG and excessive GWG were analyzed by multinomial logistic regression. Results The average weight gain of the subjects during pregnancy was (15.6 +5.2) kg. Pregnant women with inadequate, adequate and excessive GWG were 14.7%, 35.7% and 49.6% respectively. Pre-pregnancy overweight/obesity, primary delivery, history of cesarean section or macrosomia, conceived in spring or summer were risk factors for excessive weight gain, while primary school and below education was risk factor inadequate GWG. Conclusion Pre-pregnancy nutritional status, pregnancy and childbirth history, education level, pregnancy season and childbirth year have influence on pregnancy weight gain. Reasonable measures for weight management during pregnancy should be formulated according to the risk factors of inadequate or excessive GWG.