双胎孕妇体重、受孕方式与妊娠并发症及不良母婴结局相关性

Correlation between weight, assisted reproduction situation, and pregnancy complications of twin pregnant women and their maternal and infant outcomes

目的:分析双胎孕妇受孕方式、孕前体重、孕期增重与妊娠并发症及母婴结局的相关性。方法:回顾性收集2019年1月-2020年12月本院妇产科住院分娩的双胎妊娠孕妇212例,按照受孕方式、孕前体重和孕期增重分组,比较组间妊娠并发症与母婴结局及其相关性。结果:孕前体重与妊娠期高血压(r=0.952)、妊娠期糖尿病(r=0.806)、胎儿窘迫(r=0.825)、剖宫产率(r=0.838)呈高度正相关;孕期增重与妊娠期糖尿病呈高度正相关(r=0.865);辅助生殖技术使用(受孕方式)与妊娠期高血压(r=0.583)、妊娠期糖尿病(r=0.622)、产后出血呈中度正相关(r=0.556);孕前体重与先兆流产/早产(r=-0.798)呈中度负相关;孕期增重与妊娠期高血压(r=0.644)、剖宫产率(r=0.629)呈中度正相关,与低体重儿出生率呈中度负相关(r=-0.613)。结论:双胎孕妇采用辅助生殖技术受孕,孕前体重高于或低于正常水平,孕期体重增加过快或不足,均可引起不同妊娠并发症与不良母婴结局增高。提示临床应针对高风险人群重点干预,保护并促进母婴健康。

Objective: To analyze the correlation of pregnancy mode, pre-pregnancy weight, weight gain during pregnancy, and pregnancy complications of twin pregnant women and their maternal and infant outcomes. Methods: 212 twin pregnant women from January 2019 to December 2020 were selected retrospectively. These women were divided into diffrent groups according to the pregnancy mode, pre-pregnancy weight, and weight gain during pregnancy. The situations of pregnancy complications of the women and the maternal and infant outcomes were compared among these groups, and the correlation between the pregnancy complications of the women and the maternal and infant outcomes was analyzed. Results: Pre-pregnancy weight of the women were positively correlated with their gestational hypertension(r=0.952), with their gestational diabetes mellitus(r=0.806), with their fetal distress(r=0.825), and with their cesarean section rate(r=0.838). Weight gain during pregnancy of the women was positively correlated with their gestational diabetes mellitus(r=0.865). The assisted reproductive technology used(conception mode) of the women were moderately positively correlated with their gestational hypertension(r=0.583), gestational diabetes mellitus(r=0.622), and postpartum hemorrhage(r=0.556). Pre-pregnancy weight of the women was moderately correlated with their threatened abortion/preterm birth(r=-0.798). Weight gain during pregnancy of the women were moderately positively correlated with their gestational hypertension(r=0.644), cesarean section rate(r=0.629), but which was moderately negatively correlated with their low birth rate(r=-0.613). Conclusion: The over or less than normal pre-pregnancy weight, and the abnormal weight gain during pregnancy of the twin pregnant women after assisted reproductive technology can lead to the increase of the incidences of pregnancy complications and adverse outcomes of mother and child.For protecting the maternal and child health,the intervention of pregnant women with high-risk should be focused on.