孕前体质量指数和孕期体重控制对妊娠结局的影响

Effects of pre-pregnancy body mass index and gestational weight control on pregnancy outcome

目的 研究孕前体质量指数(BMI)、孕期体重控制对妊娠结局的影响。方法 528例足月单胎活产孕产妇,依据孕前BMI分为肥胖与消瘦组(72例)、正常体重组(456例)。依据孕期增重将正常体重组分为增重<10 kg组(33例)、增重10~15 kg组(131例)、增重>15 kg组(292例);将肥胖与消瘦组分为增重<10 kg组(7例)、增重10~15 kg组(37例)、增重>15 kg组(28例)。比较正常体重组及肥胖与消瘦组,正常体重组及肥胖与消瘦组不同增重组的不良妊娠结局发生率,包括剖宫产、妊娠高血压综合征(PIH)、妊娠期糖尿病(GDM)、新生儿窒息、巨大儿。结果 肥胖与消瘦组的剖宫产、PIH、GDM、新生儿窒息、巨大儿发生率分别为65.28%、16.67%、33.33%、6.94%、16.67%,均高于正常体重组的42.11%、6.58%、11.62%、2.19%、6.80%,差异具有统计学意义(P<0.05)。正常体重组及肥胖与消瘦组的增重<10 kg组、增重10~15 kg组、增重>15 kg组剖宫产、PIH、GDM、新生儿窒息、巨大儿发生率比较,差异无统计学意义(P>0.05)。结论 孕妇在孕前保持心情舒畅,在孕期控制好体重能够降低妊娠期各类高危表现与症状的发生。

Objective To study the effects of pre-pregnancy body mass index(BMI)and gestational weight control on pregnancy outcome.Methods A total of 528 pregnant women with full-term singleton live births were divided into obesity and emasement group(72 cases)and normal weight group(456 cases)according to pre-pregnancy BMI.According to the body weight during pregnancy,the normal weight group was divided into weight gain<10 kg group(33 cases),weight gain 10-15 kg group(131 cases),and weight gain>15 kg group(292 cases);the obesity and emasement group were divided into weight gain<10 kg group(7 cases),weight gain 10-15 kg group(37 cases),weight gain>15 kg group(28 cases).The incidences of adverse pregnancy outcomes,including cesarean section,pregnancy induced hypertension(PIH),gestational diabetes mellitus(GDM),neonatal asphyxia,and macrosomia,were compared between the normal weight group and the obesity and emasement group,and among different weight gain groups in normal weight group and the obesity and emasement group.Results The incidence rates of cesarean section,PIH,GDM,neonatal asphyxia and macrosomia in the obesity and emasement group were 65.28%,16.67%,33.33%,6.94%,and 16.67%,which were higher than 42.11%,6.58%,11.62%,2.19%,and 6.80%in the normal weight group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidences of cesarean section,PIH,GDM,neonatal asphyxia and macrosomia among the weight gain<10 kg group,the weight gain 10-15 kg group,and the weight gain>15 kg group of the normal body weight and obesity and emasement group(P>0.05).Conclusion Pregnant women who are in a good mood before pregnancy and control their weight during pregnancy can reduce the occurrence of all kinds of high-risk manifestations and symptoms during pregnancy.