超重及肥胖女性孕期BMI改变对新生儿出生体质量的影响

The Effect of BMI Changes During Pregnancy on the Birth Weight of Newborns in Overweight and Obese Women

目的探讨超重及肥胖女性孕期体质指数(BMI)改变对新生儿出生体质量的影响。方法选取2020年6月—2021年6月该院接收的800例超重肥胖孕妇(孕前BMI≥24 kg/m^(2))为研究对象,将800例孕妇随机分为普通组(n=400)和干预组(n=400)。干预组孕妇予以孕期营养系统指导干预,普通组予以常规孕期干预,同时根据孕期BMI增加幅度各分为适宜组(BMI增加<5 kg/m^(2))和超增组(BMI增加>5 kg/m^(2))4个亚组,比较各组BMI、新生儿出生体质量、大于胎龄儿(LGA)及适于胎龄儿(AGA)比例、妊娠结局。结果干预组经干预后BMI(22.15±1.08)kg/m^(2)及新生儿出生体质量(3.39±0.45)kg均低于普通组,两组比较差异有统计学意义(t=33.137、3.036,P<0.05)。普通组LGA所占比例高于干预组,超增组LGA所占比例28.77%高于适宜组7.87%,差异有统计学意义(χ^(2)=30.899,P<0.05);普通组孕妇妊高症、妊娠期糖尿病、剖宫产及巨大儿的发生率分别为1.75%、11.25%、20.50%、2.50%均较干预组更高,差异有统计学意义(χ^(2)=4.546、4.945、13.603、5.415,P<0.05)。结论孕期BMI变化对新生儿出生体质量的影响十分明显,尤其是BMI增加超过5 kg/m^(2)的孕妇会显著增加LGA发生风险。但针对超重肥胖孕妇孕期加强营养系统指导干预,可有效控制孕妇孕期体质量,从而为优化妊娠结局提供良好保障。

Objective To investigate the influence of body mass index(BMI)changes during pregnancy on the birth weight of newborns in overweight and obese women.Methods 800 cases of overweight and obese pregnant women(pre-pregnancy BMI≥24 kg/m^(2))treated in the hospital from June 2020 to June 2021 were selected as the research objects.800 pregnant women were randomly divided into general group(n=400)and intervention group(n=400).Pregnant women in the intervention group were given guidance intervention during pregnancy with the nutrition system,while the general group was given routine intervention during pregnancy.At the same time,according to the increase of BMI during pregnancy,they were divided into four subgroups:suitable group(BMI increase<5 kg/m^(2))and super-increased group(BMI increase>5 kg/m^(2)).The BMI,birth weight of newborns,ratios of infants greater than gestational age(LGA)and infants suitable for gestational age(AGA),and pregnancy outcome were compared among the groups.Results After intervention,BMI(22.15±1.08)kg/m^(2) and birth weight(3.39±0.45)kg in the intervention group were lower than those in the general group,and the differences between the two groups were statistically significant(t=33.137,3.036,P<0.05).The proportion of LGA in the general group was higher than that in the intervention group,and the proportion of LGA in the superincrease group was 28.77%higher than that in the appropriate group 7.87%,the difference was statistically significant(χ^(2)=30.899,P<0.05).The incidence of pregnancy-induced hypertension,gestational diabetes mellitus,cesarean section and macrosomia in the general group were 1.75%,11.25%,20.50%and 2.50%,respectively,higher than that in the intervention group,the difference was statistically significant(χ^(2)=4.546,4.945,13.603,5.415,P<0.05).Conclusion Changes in BMI during pregnancy have a significant impact on the birth weight of newborns,especially pregnant women whose BMI increases by more than 5 kg/m^(2) will significantly increase the risk of LGA.However,strengthening the guidance and intervention of the nutritional system during pregnancy for overweight and obese pregnant women can effectively control the weight of pregnant women during pregnancy,thereby providing a good guarantee for optimizing pregnancy outcomes.