妊娠前BMI、体重增加对妊娠并发症及结局的影响

Effect of BMI and weight gain on complications and outcomes before pregnancy

目的分析妊娠前BMI、体重增加对妊娠并发症及结局的影响。方法收集2018年1月-2019年5月在本院产检并分娩的1200例单胎、初产妇,按照妊娠前BMI分为甲组:BMI<18.5 kg/m^2(210例)、乙组:18.5 kg/m^2≤BMI≤24.9 kg/m^2(628例)和丙组:BMI>25.0 kg/m^2(362例);按照△W分为I组:7.0≤△W<11.5 kg(230例),Ⅱ组:11.5 kg≤△W≤16.0 kg(705例),Ⅲ组:12.5 kg≤△W≤18.0 kg(265例)。比较甲、乙、丙三组和Ⅰ、Ⅱ、Ⅲ组妊娠并发症及妊娠结局情况。结果丙组的妊娠糖尿病和高血压百分率均高于甲和乙组,甲组的妊娠贫血和肝内胆汁淤积症百分率均高于乙组和丙组,差异均具统计学意义(P<0.05);Ⅲ组的妊娠糖尿病和高血压百分率明显高于Ⅰ和Ⅱ组,Ⅱ组高于Ⅰ组,Ⅰ组妊娠贫血和妊娠期肝内胆汁淤积症百分率显著高于Ⅱ组和Ⅲ组,差异均有统计学意义(P<0.05);甲、乙、丙三组间对新生儿窒息、产后出血及低重儿差异无统计学意义(P>0.05),丙组的巨大儿、早产儿和剖宫产百分率高于甲和乙组,差异具统计学意义(P<0.05);Ⅰ、Ⅱ、Ⅲ三组间新生儿窒息、产后出血和低重儿无明显差异(P>0.05);Ⅲ组的巨大儿、早产儿和剖宫产百分率高于Ⅰ组和Ⅱ组,Ⅰ组的早产儿百分率较Ⅱ组高,差异具统计学意义(P<0.05)。结论妊娠期BMI和体重增加与妊娠并发症及妊娠结局有一定关联,孕期体重增加应控制在一定范围。

Objective To analyze the effects of BMI and weight gain on complications and outcomes before pregnancy.Methods A total of 1200 monomorphic primiparae who underwent production inspection and delivery in our hospital from January2018 to May 2019 were divided into groups by BMI:the group A:BMI<18.5 kg/m^2(210 cases),the group B:18.5 kg/m^2≤BMI≤24.9 kg/m^2(628 cases)and the group C:BMI>25.0 kg/m^2(362 cases)and by△W:the group I:7.0≤△W<11.5 kg(230 cases),the group Ⅱ:11.5 kg≤△W≤16.0 kg(705 cases)and the groupⅢ:12.5 kg≤△W≤18.0 kg(265 cases).The pregnancy complications and pregnancy outcomes of group A,B,and C,and groupⅠ,Ⅱ,and Ⅲ were compared.Results The percentages of gestational diabetes mellitus and hypertension in the group C were higher than that of the group A and the group B;the percentages of gestational anemia and intrahepatic cholestasis in the group A were higher than that of the group B and the group C(both P<0.05).The percentage of gestational diabetes and hypertension in the groupⅢwas significantly higher than that of the group Ⅰ and Ⅱ,and the group Ⅱ was higher than that of the group Ⅰ;the percentage of gestational anemia and intrahepatic cholestasis of pregnancy in the group Ⅰ was significantly higher than that of the group Ⅱ and Ⅲ(all P<0.05).There was no significant difference in neonatal asphyxia,postpartum hemorrhage and low-weight children between the group A,B and C(P>0.05).The percentages of macrosomia,premature and cesarean section in the group C were higher than that of the group A and the group B(P<0.05).There was no significant difference in neonatal asphyxia,postpartum hemorrhage and low-weight children between the groupⅠ,Ⅱ and Ⅲ(P>0.05).The percentages of macrosomia,premature and cesarean section in the group Ⅲ was higher than that of the group Ⅰ and Ⅱ;the percentage of preterm infants in the group Ⅰ was higher than that of the group Ⅱ(P<0.05).Conclusions The BMI and weight gain during pregnancy are related to pregnancy complications and pregnancy outcomes;hence,the weight gain during pregnancy should be controlled to a certain extent.