孕期体重管理对控制新生儿出生体重分析

The effect of gestational weight management on neonatal birth weight control

目的探讨基层妇保人员参与的孕期体重管理对降低巨大儿出生率的影响。方法对基层妇保人员进行孕期体重管理培训,选取安吉县早孕建册的孕妇进行前瞻性对照研究,随机分为研究组180例,对照组175例。根据孕前体质指数,确定孕期体重总增重和增重速率,以体重管理的结果指导孕妇饮食,记录孕期增重、新生儿体重、自然分娩、纯母乳喂养、并发妊娠期糖尿病等情况。结果研究组孕期增重及巨大儿出生率低于对照组,自然分娩率及母乳喂养率高于对照组,在巨大儿及自然分娩率的改善中以体质指数正常者为主。结论基层妇保人员参与管理的合理的孕期增重能较好地控制新生儿体重、降低巨大儿发生率,促进自然分娩。

Objective To assess the effect of gestational weight management by participation of grass-roots maternity care workers in decreasing the birth rate of macrosomia. Methods Grass-roots maternity care workers undertook the training of gestational weight management. A prospective cohort study was made by selecting pregnant women who were registered with health centre when early pregnancy and were randomized into the research group( n = 180) and the control group( n = 175). Based on pre-pregnancy body mass index( BMI) the total prenatal weight gain and weight gain rate was determined and the outcomes of weight management were used to guide the diet of pregnant women and records were made of prenatal weight gain,neonatal weight,natural delivery,breastfeeding,and gestational diabetes mellitus( GDM). Results Compared with the control group,the research group had lower prenatal weight gain and macrosomia but higher natural delivery and breastfeeding. Those who had improved condition of macrosomia and natural delivery were mainly women with normal BMI. Conclusions Optimal prenatal weight gain managed by grass-roots maternity care workers can control neonatal weight,decrease the incidence of macrosomia and promote natural delivery.