1985年与2018年福州市孕妇孕期增重的比较研究

A Compare Research of Gestational Weight Gain of Pregnant Woman in Fuzhou in 1985 and 2018

目的了解不同时期孕前体质指数(body mass index,BMI)与孕期增重(gestational weight gain,GWG)对新生儿出生体质量的影响,为孕期营养管理提供依据。方法收集1985年与2018年福州市主要城区的单胎初产妇信息,对两组人群的孕前BMI、GWG及新生儿体质量等临床资料进行比较分析。结果纳入研究对象2393例,其中1985年1138例,2018年1255例。2018年孕妇的孕前体质量、身高、孕前BMI和GWG[分别为(51.91±7.32)kg、(161.15±4.79)cm、(19.98±2.55)k g/m^(2)、(14.90±3.96)kg]均高于1985年[分别为(48.83±5.81)kg、(158.85±5.19)cm、(19.31±2.26)kg/m^(2)、(10.74±4.49)kg],t值分别为11.324、11.273、6.774和23.357,P值均<0.001。新生儿出生体质量由1985年的(3153.91±429.79)g升至2018年的(3333.73±393.74)g(t=10.681,P<0.001),巨大儿发生率由2.7%升至4.9%(χ^(2)=7.847,P=0.005),剖宫产率由10.2%上升至12.8%(χ^(2)=4.050,P=0.044),而低出生体质量发生率由4.3%降至1.6%(χ^(2)=15.678,P<0.001)。孕妇孕前BMI和GWG与新生儿出生体质量成正比。结论随着群众生活水平的改善,该地区围产期保健水平有所提高,但孕期超重的比例增加。通过合理孕期体质量管理,控制孕前BMI、GWG在正常范围,对于降低剖宫产率,减少巨大儿发生具有重要意义。

Objective To investigate the effects of pre-pregnancy body mass index(BMI)and gestational weight gain(GWG)on the birth weight of newborns in different periods,and provide basis for nutrition management during pregnancy.Methods The information of primiparas who gave single birth in 1985 and 2018 in the main urban area of Fuzhou city was collected,and the clinical data such as pre-p regnancy BMI,GWG and newborn weight of the two groups were compared and analyzed.Results A total of 2393 subjects were collected,including 1138 in 1985 and 1255 in 2018.The pre-pregnancy weight,height,pre-pregnancy BMI and GWG[(51.91±7.32)kg,(161.15±4.79)cm,(19.98±2.55)kg/m^(2),(14.90±3.96)kg]of pregnant women in 2018 were higher than those in 1985[(48.83±5.81)kg,(158.85±5.19)cm,(19.31±2.26)kg/m^(2),(10.74±4.49)kg],t values were 11.324,11.273,6.774 and 23.357,P values were all<0.001.The birth weight of newborns increased from(3153.91±429.79)g in 1985 to(3333.73±393.74)g in 2018(t=10.681,P<0.001),and the incidence of fetal macrosomia increased from^(2).7%to 4.9%(χ^(2)=7.847,P=0.005),and the rate of cesarean delivery increased from 10.2%to 12.8%(χ^(2)=4.050,P=0.044),and the rate of low birth weight of newborns decreased from 4.3%to 1.6%(χ^(2)=15.678,P<0.001).Both the pre-pregnancy BMI and GWG are positively correlated with the birth weight of newborns.Conclusion With the improvement of the people’s living standards,the perinatal health care level in this area has improved,but the proportion of overweight people during pregnancy has increased significantly.Reasonable weight management during pregnancy and active control of pre-pregnancy BMI in the normal range are of great significance for reducing the rate of cesarean delivery and reducing the occurrence of fetal macrosomia.