孕期体重增长与妊娠结局关系的探讨

Relationship between weight gain and pregnancy outcome during pregnancy

目的探讨基于孕前体质量指数(BMI,单位为kg/m2)分组的孕期体重增长与妊娠结局关系。方法选择2019年1月至2020年1月按期完成产前检查并分娩的500例产妇的临床资料进行回顾性分析。按2018版《孕前和孕期保健指南》提出孕前及孕期体质量增加建议,将样本分为四组:低体重组、正常体重组、超重组和肥胖组。各组按其不同总增长幅度再分为体重增长不足、体重增长正常和体重增长过多组,记录妊娠期高血压、妊娠期糖尿病、剖宫产、巨大儿、低出生体重儿及产后出血的人数,并计算其发生率。结果孕前低体重及正常体重组的孕妇孕期不同体重增长范围与妊娠期高血压、妊娠期糖尿病、巨大儿、低出生体重儿、剖宫产及产后出血发生率差异无显著性,无统计学意义(P>0.05)。孕前超重、肥胖孕妇孕期不同体重增长范围与妊娠期高血压、妊娠期糖尿病、剖宫产及产后出血的发生率差异有统计学意义(P<0.05)。孕前超重组的孕妇孕期体重不同范围的增长致分娩后低出生体重儿的发生率差异无显著性,无统计学意义(P>0.05),但比较巨大儿发生率差异有统计学意义(P<0.05)。孕前肥胖组的孕妇孕期体重不同范围的增长致分娩后巨大儿的发生率差异无显著性,无统计学意义(P>0.05),但比较低出生体重儿发生率,差异具有统计学意义(P<0.05)。结论经研究超重组、肥胖组孕前BMI数值过高、孕期体重增长过快,均增加妊娠不良结局的发生率。

Objective To explore the relationship between pregnancy weight gain and pregnancy outcome based on pre-pregnancy body mass index(BMI,kg/m2)group.Methods The clinical data of 500parturients who completed prenatal examination and delivered from January 2019to January 2020were retrospectively analyzed.According to the 2018edition of the guidelines for pre-pregnancy and pregnancy health care,the samples were divided into four groups:low body recombination,normal body recombination,overweight group and obesity group.The number of patients with gestational hypertension,gestational diabetes mellitus,cesarean section,macrosomia,low birth weight infants and postpartum hemorrhage were recorded and calculated.Results During pregnancy,the incidence of gestational hypertension,gestational diabetes mellitus,macrosomia,low birth weight infants,cesarean section and postpartum hemorrhage in pregnant women with low body recombination and normal body recombination had no significant difference(P>0.05).Before pregnancy,the incidence of hypertension,gestational diabetes mellitus,cesarean section and postpartum hemorrhage in pregnant women with overweight and obesity was statistically significant(P<0.05).There was no significant difference in the incidence of low birth weight infants after delivery in the pregnant overweight group before pregnancy(P>0.05),but there was significant difference in the incidence of giant infants(P>0.05).There was no significant difference in the incidence of macrosomia after delivery(P>0.05),but the incidence of low birth weight was statistically significant(P<0.05).Conclusion After the study,the incidence of adverse pregnancy outcomes was increased by over-recombination,high pre-pregnancy bmi values and too fast weight gain during pregnancy.