妊娠体质量增加与孕前体质量指数对产科结局的影响

Effect of gestational weight gain and pre-pregnancy body mass index on obstetric outcome

目的:探讨妊娠体质量增加与孕前体质量指数对产科结局的影响,以期指导合理的孕期增重。方法:回顾性分析3190例足月单胎活产孕产妇的临床资料,按孕前体质量指数将孕妇分为低体质量组、标准组、超重组,再按照妊娠体质量增加情况分为低标组、达标组、超标组,对组间相关临床参数进行比较,分析不同孕前体质量指数和妊娠体质量增加量对产科结局的影响。结果:标准体质量指数的孕妇占68.5%,超重组的剖宫产率、产钳助产率、巨大儿出生率、新生儿窒息率、第一产程及第二产程均高于低体质量组和标准组;超标组的剖宫产率、产钳助产率、巨大儿出生率、新生儿窒息率均高于低标组和达标组;低标组的低体质量儿发生率明显高于达标组和超标组(P<0.05)。结论:孕前体质量指数过大和妊娠体质量增加过多可对产科结局造成负面影响。应指导育龄妇女保持正常的孕前体质量和合理的孕期增重,从而改善不良产科结局。

Objective:To investigate the effects of gestational weight gain and pre-pregnancy body mass index(BMI) on obstetric outcome,and guide reasonable weight gain during pregnancy. Methods:The clinical data of 3 190 term singleton live births pregnant women were retrospectively analyzed.The patients were divided into the low weight group,normal weight group and overweight group based on the pre-pregnancy BMI,and the below standard group,reach standard group and exceed standard group according to the weight increasing during pregnancy.The clinical parameters among different groups were compared to analyze the influence of the pregestational body mass index and pregnancy body gain on obstetric outcome. Results:The pregnant women with standard(BMI) accounted for 68.5%,and the cesarean section rate,forceps midwifery rate,macrosomia birth rate,neonatal asphyxia rate,the first and second stages of labor in overweight group were significantly higher than those in low weight group and normal weight group.The cesarean section rate,forceps midwifery rate,macrosomia birth rate and neonatal asphyxia rate in overstandard group were significantly higher than those in reach standard group and exceed standard group.The incidence rate of low body mass children in low standard group was significantly higher than that in reach standard group and exceed standard group( P <0.05). Conclusions:Excessive BMI before pregnancy and excessive pregnancy weight gain can negatively affect on obstetric outcomes.Women of child-bearing age should be guided to maintain normal pre-pregnancy weight and reasonable pregnancy weight gain so as to improve obstetric outcomes.