北京市孕妇孕期增重影响因素对母婴健康的不良影响分析

Analysis of the influencing factors and the adverse effect of gestational weight gain maternal and infant health in Beijing

目的:分析北京市孕妇孕期增重状况、影响因素及不良影响。方法:选取2018年6月至2019年6月于北京市某三甲医院儿保中心建档的婴儿及其母亲为研究对象,采用问卷调查法,利用自制的问卷调查表收集产妇的基本信息。采用卡方检验和方差分析对研究对象的基本特征及孕期增重对母婴健康的不良影响进行分析,多元Logistic回归用于分析孕期增重不足及过多的影响因素。结果:共纳入3732对产妇及其婴儿。产妇平均孕期增重为13.0 kg,孕期增重不足的比例为31.8%,增重过多的比例为24.1%。低龄,孕前BMI超重和肥胖,初产,学历较低是孕期增重过多的危险因素;孕前超重和肥胖的产妇其孕期增重过多的风险是孕前体重正常产妇的2.40倍(OR=2.40,95%CI=1.91~3.03,P<0.001)和2.90倍(OR=2.90,95%CI=1.59~5.27,P<0.001)。此外,研究发现孕期增重过多显著增加巨大儿的发病风险,并显著增加了产妇剖宫产,妊娠高血压和产后体重滞留的风险。结论:影响孕期增重的因素主要包括年龄、孕前BMI、初产妇、教育程度等。考虑到孕期增重不良对母婴健康带来的严重不良影响,未来的孕期保健工作中应加强这些高危人群孕妇的孕期体重管理工作。

Objective To determine the gestational weight gain and its risk factors and adverse effects among pregnant women in Beijing.Methods Between June 2018 and June 2019,all registered infants and their mothers in a child care center of a third-tier-class hospital in Beijing were selected.A self-made questionnaire was used to collect the basic information of the maternal mothers.Chi-square test and analysis of variance were used to describe the basic characteristics of the study subjects and clarify the harmful effect of gestational weight gain for maternal and infant health.Multiple logistic regression analysis was used to analyze the risk factors of both insufficient and excessive weight gain during pregnancy.Results A total of 3732 maternal mothers and their babies were included.The average weight gain of maternal mothers during pregnancy was 13.0 kg.The results of this study showed that the proportion of insufficient weight gain during pregnancy was 31.8%and the proportion of excessive weight gain was 24.1%.It was further found that young age,pre-pregnancy body mass index indicating overweight and obesity,primipara,and low education were independent risk factors for excessive weight gain during pregnancy.The risk of excessive weight gain of pre-pregnancy overweight and obesity was 2.40 times(OR=2.40,95%CI=1.91-3.03,P<0.001)and 2.90 times higher,respectively,(OR=2.90,95%CI=1.59-5.27,P<0.001)when compared with that of pre-pregnancy normal weight.In addition,our results suggested that excessive weight gain significantly increased the risk of macrosomia for the infant and the risk of cesarean section,gestational hypertension,and postpartum weight retention for maternal mothers.Conclusions Age,pre-pregnancy BMI,primipara,and education level were the influencing factors for gestational weight gain.Considering the serious harmful effects of both insufficient and excessive weight gain for maternal and infant health,weight management during pregnancy should be strengthened for these high-risk populations in the future.