孕期增重过度的影响因素分析

Factors affecting excessive weight gain during pregnancy

目的 了解西宁市孕产妇孕期增重过度现状并分析影响因素,为合理控制孕期体重提供依据。方法 选择2021年8月—2022年7月在青海省红十字医院、青海大学附属医院和西宁市第一人民医院登记建档并分娩的孕产妇为调查对象。通过产检资料和调查问卷收集人口学信息、孕期健康状况、饮食、睡眠和运动情况。依据T/CNSS 009—2021《中国妇女妊娠期体重监测与评价》判断孕期增重是否过度;采用多因素logistic回归模型分析孕期增重过度的影响因素。结果 发放问卷902份,回收有效问卷882份,回收有效率为97.78%。孕产妇年龄为(29.06±4.16)岁。初产妇447人,占50.68%。孕前体质指数(BMI)为(20.44±2.20) kg/m^(2)。孕期增重(14.17±3.11) kg,孕期增重过度360例,占40.82%。多因素logistic回归分析结果显示,高中/中专学历(OR=1.400,95%CI:1.037~1.889)、家庭年收入>20万元(OR=2.385,95%CI:1.924~2.956)、有糖尿病家族史(OR=1.475,95%CI:1.180~1.844)、孕前超重/肥胖(OR=4.079,95%CI:2.471~6.734)、患妊娠高血压(OR=2.061,95%CI:1.027~4.136)、焦虑(OR=1.315,95%CI:1.139~1.518)和偏好酸食(OR=1.715,95%CI:1.237~2.376)是孕期增重过度的危险因素,有早孕反应(OR=0.636,95%CI:0.546~0.742)是孕期增重过度的保护因素。结论 西宁市孕产妇孕期增重过度比例较高,文化程度、家庭年收入、糖尿病家族史、孕前BMI、孕期并发症和饮食习惯是主要影响因素。

Objective To investigate the current prevalence of excessive weight gain during pregnancy among pregnant and lying-in women in Xining City and to identify the influencing factors,so as to provide insights into reasonable weight control during pregnancy.Methods The pregnant and lying-in women who were registered and delivered in the Red Cross Hospital of Qinghai Province,the Affiliated Hospital of Qinghai University and the First People's Hospital of Xining City from August 2021 to July 2022 were enrolled.Women's demographics,health status during pregnancy,diet,sleep and exercise were collected through prenatal testing data and questionnaires.Excessive weight gain during pregnan⁃cy was identified according to"Weight monitoring and evaluation during pregnancy of Chinese Women"(T/CNSS 009-2021),and the factors affecting excessive weight gain during pregnancy were identified using a multivariable logistic re⁃gression model.Results A total of 902 questionnaires were allocated and 882 valid questionnaires were recovered,with an effective recovery rate of 97.78%.The pregnant and lying-in women had a mean age of(29.06±4.16)years,mean pregestational body mass index of(20.44±2.20)kg/m^(2) and mean gestational weight gain of(14.17±3.11)kg,and there were 447 primiparas(50.68%)and 360 women with excessive weight gain during pregnancy(40.82%).Multivariable lo⁃gistic regression analysis identified an educational level of senior high school/technical secondary school(OR=1.400,95%CI:1.037-1.889),annual household income of>200000 Yuan(OR=2.385,95%CI:1.924-2.956),a family history of diabetes(OR=1.475,95%CI:1.180-1.844),pregestational overweight/obesity(OR=4.079,95%CI:2.471-6.734),gesta⁃tional hypertension(OR=2.061,95%CI:1.027-4.136),anxiety(OR=1.315,95%CI:1.139-1.518)and preference for sour foods(OR=1.715,95%CI:1.237-2.376)as risk factors for excessive weight gain during pregnancy,and early pregnancy reaction as a protective factor(OR=0.636,95%CI:0.546-0.742).Conclusions The prevalence of excessive weight gain during pregnancy was high in Xining City,and educational level,annual household income,family history of diabetes,pregestational body mass index,pregnant complications and dietary habits are factors affecting excessive weight gain dur⁃ing pregnancy.