孕前低体重指数对妊娠结局的影响

Association of low pre-pregnancy body mass index with pregnancy outcomes

目的研究孕前低体重指数对妊娠结局的影响。方法2019年7月1日-2019年12月31日在同济大学附属上海市第一妇婴保健院住院分娩孕妇,单胎、≥26周、活产,按孕前BMI分为极低体重组(BMI<16.5 kg/m^(2),n=104)、低体重组(BMI为16.5~18.4 kg/m^(2),n=969)、正常组(BMI为18.5~23.9 kg/m^(2),n=5885)、超重组(BMI为24~27.9 kg/m^(2),n=1081)、肥胖组(BMI≥28 kg/m^(2),n=237),把妊娠期高血压疾病、妊娠期糖尿病、早产、小于孕龄儿、大于孕龄儿定义为不良妊娠结局,分析比较不同孕前体重指数组别不良妊娠结局的发生率和发生风险。结果低体重组发生妊娠期高血压疾病(1.14%vs 3.62%,AOR=0.28,95%CI 0.15~0.52,P<0.01)、妊娠期糖尿病(6.40%vs 8.73%,AOR=0.75,95%CI 0.57~0.99,P<0.05)、大于孕龄儿(2.58%vs 5.68%,AOR=0.45,95%CI 0.30~0.69,P<0.01)的风险均低于正常组,发生小于孕龄儿(7.12%vs 4.45%,AOR=1.55,95%CI 1.17~2.05,P<0.01)的风险高于正常组,发生综合不良妊娠结局的风险并不高于正常组(18.78%vs 22.92%,AOR=0.74,95%CI 0.62~0.89,P<0.01)。结论孕前低体重指数不影响综合不良妊娠结局。

Objective To investigate the association of low pre-pregnancy body mass index(BMI)with pregnancy outcomes.Methods A total of 8276 singleton pregnant women with≥26 gestation age who delivered in Shanghai First Maternity and Infant Hospital from July 2019 to December 2019 were enrolled in the study.There were 104 cases of extremely low body weight(BMI<16.5 kg/m^(2)),969 cases of low body weight(BMI 16.5-18.4 kg/m^(2)),5885 of normal weight(BMI 18.5-23.9 kg/m^(2)),1081 cases of overweight(BMI 24-27.9 kg/m^(2))and 237 cases of obesity(BMI≥28 kg/m^(2)).Hypertensive disorders of pregnancy(HDP),gestational diabetes mellitus(GDM),premature delivery,small for gestational age infant(SGA),large for gestational age infant(LGA)were defined as adverse pregnancy outcomes.The incidences and risks of adverse pregnancy outcomes and the differences among different groups were analyzed and compared.Results Compared with the normal group,the risk of HDP(1.14%vs 3.62%,AOR=0.28,95%CI 0.15-0.52,P<0.01),GDM(6.40%vs 8.73%,AOR=0.75,95%CI 0.57-0.99,P<0.05)and LGA(2.58%vs 5.68%,AOR=0.45,95%CI 0.30-0.69,P<0.01)were lower in the low body weight group,but the risk of SGA infant(7.12%vs 4.45%,AOR=1.55,95%CI 1.17-2.05,P<0.01)was higher;however,the risk rate of overall adverse pregnancy outcomes was not higher than that of normal group(18.78%vs 22.92%,AOR=0.74,95%CI 0.62-0.89,P<0.01).Conclusion Low pre-pregnant BMI is not associated with the increased risks of overall adverse pregnancy outcomes.