妊娠期体重增加与妊娠期代谢异常及母儿结局

Relationship between gestational weight gain and metabolic abnormalities during pregnancy as well as maternal and neonatal outcomes

孕产妇妊娠期增重越来越受到医护人员的关注。2009年美国医学研究所推出了妊娠期体重增加的推荐意见,指导孕前消瘦、正常体重、超重、肥胖的孕妇在妊娠期合理增重。妊娠期体重不适当增加对于孕产妇及新生儿均有不利影响,并与糖代谢异常存在联系。妊娠期增重过多可增加孕妇妊娠期合并症、剖宫产、孕产妇远期代谢性疾病以及新生儿大于胎龄儿、巨大儿风险。妊娠期增重不足可引起孕妇早产风险、新生儿低体重儿、小于胎龄儿风险增加。临床工作者应根据孕产妇孕前体重指数确定孕妇妊娠期合理增重速度,制定相应的管理措施。

Recently,the gestational weight gain(GWG)has been attracting more and more attentions from clinical workers.In 2009,the Institute of Medicine of America has released new guidelines for weight gain during pregnancy.The recommendation is for underweight,normal weight,overweight,and obese women before pregnancy to gain appropriate weight during pregnancy.Inappropriate GWG has adverse effects on pregnant women and newborns.There are strong association between maternal inappropriate GWG and glucose metabolism.Women with excess GWG are associated with the increased risk of gestational complication,cesarean delivery,postpartum metabolic disease,macrosomia and large-for-gestational-age(LGA)infants.Women with inadequate GWG are associated with the increased risk of premature delivery,low-birth-weight(LBW)and small-for-gestational-age(SGA)infants.Medical workers should make personalized weight management program according to the reasonable rate of GWG based on pre-pregnancy body mass index.