妊娠期正常高值血压产妇体质量及妊娠结局的回顾性分析

Body weight and gestational outcomes in women with high normotension during pregnancy

目的:研究妊娠期正常高值血压产妇的孕前体质指数、孕期体质量增加及妊娠结局。方法:回顾性分析2015-2017年在上海市松江区妇幼保健院产检并分娩的妊娠期正常高值血压、正常血压、妊娠期高血压疾病(HDP)各500例产妇的临床资料,比较三组孕前体质指数、孕期体质量增加及妊娠结局,并分析三者的相关性。结果:正常高值血压组、正常血压组孕前体质指数、孕期体质量增加差异有统计学意义(均P<0.017);正常高值血压组、HDP组孕前体质指数差异有统计学意义(P<0.017)。妊娠不良结局方面,除早产率略低于正常血压组外,羊水过少、胎盘早剥、产后出血、胎儿窘迫和小于孕龄儿的发生率正常高值血压组与正常血压组差异均无统计学意义(均P>0.017);HDP组羊水过少、胎盘早剥、剖宫产、产后出血、早产和小于孕龄儿的发生率均高于正常高值血压组,差异均有统计学意义(均P<0.01)。孕期正常高值血压的产妇不良妊娠结局亚组孕期体质量增加过少及过多的比例均高于无不良妊娠结局亚组产妇,孕期体质量增加正常的比例低于无不良妊娠结局亚组,差异有统计学意义(均P<0.01)。结论:孕前体质指数、孕期体质量增加与孕期血压水平和妊娠结局相关,合理干预妊娠期正常高值血压孕妇的孕期体质量对改善不良妊娠结局有一定意义。

Objective: To investigate the pre-pregnancy body mass index(BMI), gestational weight gain(GWG)and gestational outcomes in women with high normotension during pregnancy. Methods: The clinical data of 1500 pregnant women who recieved antenatal care and delivered in Songjiang District Maternal and Child Hospital, Shanghai from 2015 to 2017 were retrospectively analyzed. The women were divided into high normotension group, normotension group and hypertensive disorder of pregnancy(HDP) group with 500 cases in each group. The general information, pre-pregnancy body mass index, gestational weight gain and gestational outcomes were analyzed. Results: There were significant differences in pre-pregnancy BMI and GWG between the high normotension group and the normotension group(all P<0.017), and there was significant difference in pre-pregnancy BMI between the high normotension group and HDP group(P<0.017). In terms of adverse pregnancy outcomes, the incidence of oligohydramnios, placental abruption, postpartum hemorrhage, fetal distress and small for gestational age infant were higher in the high normotension group than those in the normotension group, but the differences were not of statistical significance(all P>0.017);the incidence of oligohydramnios, placental abruption, cesarean section, postpartum hemorrhage, premature delivery and small for gestational age infant in HDP group were higher than those in high normotension group(all P<0.01). In high normotension women with adverse gestational outcomes, the proportion of low GWG or too much GWG was higher and the proportion of normal GWG was lower than those in high normotension women without adverse gestational outcomes(all P<0.01).Conclusions: Pre-pregnancy BMI and GWG are correlated with pregnancy blood pressure and gestational outcomes. Reasonable intervention to gestational weight gain of pregnant women with high normotension is of significance to improve the gestational outcomes.