初次妊娠女性妊娠期内BMI增速对妊娠结局的影响

Effect of body mass index growth during pregnancy on pregnancy outcome of primigravid women

目的探讨初次妊娠女性妊娠期内体重指数(BMI)增速对妊娠结局的影响。方法选取2016年2月~2018年12月于我院产检并分娩的316例初次妊娠的女性作为研究对象。根据其孕前BMI不同分为低BMI组(BMI<18.5 kg/m2)66例、正常组(18.5 kg/m2≤BMI<24 kg/m2)98例和超重组(BMI≥24 kg/m2)152例。根据其孕前至终止妊娠时BMI增长速度的不同分为低速组(BMI增速<4 kg/m2)44例、中速组(4 kg/m2≤BMI增速<6 kg/m2)106例和高速组(BMI增速≥6 kg/m2)166例,对比分析研究对象妊娠结局情况和新生儿结局情况。结果超重组孕妇剖宫产、子痫前期、胎盘早剥、早产和酮症酸中毒的发生率均明显高于低BMI组和正常组(P<0.05);高速组剖宫产、子痫前期、胎盘早剥、早产和酮症酸中毒的发生率明显高于低速组和中速组(P<0.05)。超重组新生儿出现低体重儿、巨大儿、新生儿窒息、新生儿低血糖和高胆红素血症的情况明显多于低BMI组和正常组(P<0.05);中速组新生儿出现巨大儿、新生儿窒息、新生儿低血糖、高胆红素血症和畸形的情况明显少于低速组和高速组(P<0.05)。结论初次妊娠女性BMI增速过快或过慢均会造成不良妊娠结局和新生儿不良结局的发生。合理监测妊娠期女性BMI增速情况能够有效评估其预后,提前做好干预措施,降低不良妊娠结局的发生率。

Objective To explore the effect of body mass index(BMI)growth during pregnancy on pregnancy outcome of primigravid women.Methods A total of 316 primigravid women who underwent antenatal examination in our hospital from February 2016 to December 2018 were selected as objects.According to BMI,they were divided into the low BMI group(BMI<18.5 kg/m2,n=66),the normal group(18.5 kg/m2<24 kg/m2,n=98)and the overweight group(BMI≥24 kg/m2,n=152).According to the difference of BMI growth rate from pre-pregnancy to termination of pregnancy,they were divided into the low speed group(BMI growth rate<4 kg/m2,n=44),the medium speed group(4 kg/m2≤BMI growth rate<6 kg/m2,n=106)and the high speed group(BMI growth rate≥6 kg/m2,n=166).The pregnancy outcome and neonatal outcome of the objects were compared and analyzed.Results The incidences of cesarean section,preeclampsia,placental abruption,preterm delivery and ketoacidosis in the overweight pregnant women were significantly higher than those in low BMI group and normal group(P<0.05),and the incidences of cesarean section,preeclampsia,placental abruption,preterm delivery and ketoacidosis in the high speed group were significantly higher than those in low speed group and medium speed group(P<0.05).The incidence of hypoglycemia,macrosomia,neonatal asphyxia,neonatal hypoglycemia and hyperbilirubinemia in the overweight newborns was significantly higher than that in the low BMI group and normal group(P<0.05).The incidence of macrosomia,neonatal asphyxia,neonatal hypoglycemia,hyperbilirubinemia and malformation in the medium speed group was significantly lower than that in the low speed group and high speed group(P<0.05).Conclusion The high or slow growth rate of BMI in primigravid women will lead to adverse pregnancy outcome and neonatal adverse outcome.Reasonable monitoring of the growth rate of BMI during pregnancy can effectively evaluate the prognosis,so it is necessary to take intervention measures in advance,and reduce the incidence of adverse pregnancy outcomes.