2015年中国女性妊娠中晚期增重状况及影响因素

Gestational weight gain and associated factors of Chinese women in the second and third trimester of pregnancy in 2015

目的调查中国2015年孕妇孕前体重及妊娠中晚期增重状况,探讨妊娠中晚期增重的影响因素。方法利用2010-2012年中国居民营养与健康状况监测调查数据和2015年中国成人慢性病与营养监测两轮调查数据进行分析。两轮监测均采用多阶段分层与人口成比例整群随机抽样方法选取样本,2015年共采集样本8512名,通过问卷调查收集孕妇一般情况和孕前体重,测量身高和体重。结果以中国体质指数标准判定,2015年孕妇孕前低体重率、适宜率、超重率和肥胖率分别为16.0%.66.0%、14.9%和3.1%。孕妇妊娠中期增重不足率、适宜率和过多率分别为14.6%、27.2%和58.2%,妊娠晚期增重不足率、适宜率和过多率分别为12.7%、31.5%和55.8%。孕前超重女性较孕前适宜体重者发生妊娠中期增重过多的比值比为1.53(95%CI 1.19~1.99),发生妊娠晚期增重过多的比值比为2.05(95%CI 1.59~2.63)。与2012年比较,2015年孕期增重过多率城乡均呈升高趋势。经产妇(生育第二胎)是妊娠晚期增重适宜的保护因素。结论2015年中国孕妇孕前低体重、妊娠中晚期增重不足情况得到改善,但孕前超重率、肥胖率和妊娠中晚期增重过多率增加。

OBJECTIVE To describe gestational weight gain status of pregnant women in China, and to explore potential factors related to gestational weight gain of pregnant women in the 2 nd and 3 rd trimester in 2015.METHODS Participants were from Chinese National Nutrition and Health Surveillance in 2012 and in 2015. Using a multi-stage stratified cluster random sampling method, a total of 8512 pregnant women were recruited in 2015. A standard questionnaire was used to collect general information and pre-pregnancy weight. Body weight and height of pregnant women were measured using a unified weighing scale and stadiometer.RESULTS In 2015, the prevalences of underweight, normal weight, overweight and obesity in pre-pregnancy were 16.0%,66.0%, 14.9%, 3.1% according to Chinese BMI standard, respectively. In the 2 nd trimester, the prevalences of inadequate gestational weight gain, appropriate gestational weight gain and excess gestational weight gain were 14.6%, 27.2% and 58.2% based on IOM gestational weight gain standard, respectively. In the 3 rd trimester, the prevalences of inadequate gestational weight gain, appropriate gestational weight gain and excess gestational weight gain were 12.7%, 31.5%, 55.8% based on IOM gestational weight gain standard, respectively. The odds of excess gestational weight gain was 1.53(95%CI 1.19-1.99) in the second trimester, and 2.05(95% CI 1.59-2.63) in the third trimester for overweight women, compared to normal weight women during pre-pregnancy. The prevalence of excess gestational weight gain showed an increasing trend in both urban and rural areas, which was not related to pregnant women’s age and education. Second parity might be a protective factor for appropriate weight gain in late pregnancy.CONCLUSION Compared to 2012, the prevalence of underweight before pregnancy and inadequate gestaional weight gain decreased in 2015. By contrast, the prevalence of overweight, obesity and excess gestational weight gain showed an upward trend.