人口学与生活方式行为因素对孕妇孕期增重情况的影响——一项前瞻性队列研究

Effects of demographic and lifestyle behavior factors on gestational weight gain of pregnant women:A prospective cohort study

目的了解孕妇孕期增重(GWG)现况,探讨社会人口学因素及孕期生活方式行为因素对孕妇GWG的影响。方法2020年4-7月招募1200例孕12~14周且单胎的孕妇开展前瞻性的队列研究,采用问卷调查的方法收集孕妇孕期生活方式相关资料,通过医院信息系统收集孕妇建卡人口学资料并追踪随访GWG情况,随访过程中剔除非足月分娩或体质量记录不完整者228例。采用logistic回归分析探究孕期增重的影响因素。结果共纳入972例单胎活产孕妇,GWG为(14.28±4.71)kg,其中增重适宜、不足和过多分别为419例(43.1%)、229例(23.6%)和324例(33.3%)。增重不足的危险因素包括高龄、研究生学历、进餐次数增加或减少、供餐方式为家人或保姆做饭及锻炼时长增加,而睡眠质量变好是其保护性因素;增重过多的危险因素为中专及以下学历、孕前超重或肥胖、总体进食量增加及户外活动时间减少,而孕前偏瘦为其保护性因素。结论孕妇GWG不适宜比例较高且问题突出,孕期生活方式的改变对GWG具有较大的影响,GWG不足和过多具有不同的危险因素。对有GWG不足/过多风险的孕妇,建议在临床孕期保健中增加对其生活方式的评估,并根据评估结果给予针对性指导。

Objective To understand the current status of gestational weight gain(GWG)in pregnant women,and to explore the influence of their sociodemographic factors and lifestyle-related factors during pregnancy on GWG.Method From April to July 2020,1200 pregnant women with singletons at 12-14 weeks pregnancy was recruited for a prospective cohort study.Questionnaire survey was used to collect data on lifestyle during pregnancy.Demographic data of pregnant women were collected through the Hospital Electronic Medical Record System,and their GWG were follow up.During the follow-up,228 cases of non-term delivery or incomplete weight records were excluded.Logistic regression analysis was used to explore the influencing factors of GWG.Results A total of 972 pregnant women with single live birth were enrolled.GWG was(14.28±4.71)kg,of which the cases of appropriate,insufficient,and excessive GWG were 419(43.1%),229(23.6%),and 324(33.3%),respectively.Risk factors of insufficient GWG included advanced age,postgraduate education,increased or decreased frequency of meals,meals served by family members or nanny,and increased exercise time,while better sleep quality was a protective factor;Risk factors of excessive GWG were secondary school education or below,overweight or obesity before pregnancy,increased overall food intake,and reduced outdoor activity,while underweight before pregnancy was a protective factor.Conclusion The proportion of pregnant women with inappropriate weight gain is high and the problems is prominent.The change of gestational lifestyle has a great impact on GWG.Insufficient and excessive GWG during pregnancy have different risk factors.For pregnant women at risk of insufficient or excessive GWG during pregnancy,it is recommended to add the assessment of lifestyle in clinical pregnancy health care,and give targeted guidance according to the assessment results.