孕妇孕前BMI和孕期增重对新生儿出生体重的影响及其交互作用

Effects of Prenatal BMI and Gestational Weight Gain on Neonatal Birth Weight and Their Interaction

目的研究孕妇妊娠前BMI、妊娠期间增重与新生儿出生体重之间的关系,及二者之间是否存在交互作用。方法将2018年3月-2019年3月收入院的2780例孕妇纳入本次研究,通过调查问卷以及医院电子病历信息系统收集孕妇及其新生儿的一般资料和临床资料,采用队列研究法以及相关统计学方法进行分析。结果新生儿出生体重小于胎龄儿347例(12.48%),大于胎龄儿268例(9.64%),单因素分析显示,孕妇合并高血压或糖尿病并发症,孕妇孕周、孕妇妊娠前BMI以及孕妇妊娠期间增重均可影响新生儿的出生体重,(P<0.05);与正常体重组比较,妊娠前低体重、妊娠期间增重不足可增加发生小于胎龄儿的风险,妊娠前肥胖/超重、妊娠期间增重过多则可增加发生大于胎龄儿的风险,且调整除孕妇妊娠前BMI和孕妇妊娠期间增重的其他变量后,得出同样结论;采用相乘、相加模型分析后显示,孕妇妊娠前BMI、妊娠期间增重对新生儿出生体重影响无交互作用。结论孕妇妊娠前BMI、妊娠期间增重均可影响新生儿的出生体重,即孕妇妊娠前超重或体重过低,妊娠期间增重不足或过多,都可增加新生儿出生体重不符合胎龄这一不良情况的发生率,二者对新生儿体重的影响并不存在交互作用。

Objectives To study the relationship between maternal pre-pregnancy body mass index(BMI),weight gain during pregnancy and neonatal birth weight,and analyze whether there was interaction between them.Methods 2780 pregnant women were included in this study.The general and clinical data of 2780 pregnant women and their newborns were collected through questionnaires and hospital electronic medical record information system.The relationship between pre-pregnancy BMI,weight gain during pregnancy and birth weight of newborns was analyzed by cohort study and related statistical methods,and the interaction between them was explored.Results Among 2780 pregnant women,347(12.48%)were newborns with birth weight less than gestational age and 268(9.64%)were larger than gestational age.Univariate analysis showed that complications of hypertension or diabetes,gestational weeks,BMI before pregnancy and weight gain during pregnancy could affect the birth weight of newborns(P<0.05).Compared with normal weight group,low weight before pregnancy and insufficient weight gain during pregnancy can increase the risk of infants less than gestational age.Obesity/overweight before pregnancy and excessive weight gain during pregnancy can increase the risk of infants larger than gestational age.After adjusting the BMI before pregnancy and other variables of weight gain during pregnancy,the same conclusion can be drawn.Multiplication and additive model analysis showed that there was no interaction between BMI before pregnancy and weight gain during pregnancy on the birth weight of newborns.Conclusions BMI before pregnancy and weight gain during pregnancy could affect the birth weight of newborns,that was,overweight or low weight before pregnancy,underweight or excessive weight gain during pregnancy could increase the incidence of the adverse situation that the birth weight of newborns did not conform to the gestational age.However,there was no interaction between the two effects on the birth weight of newborns.