孕前超重、肥胖及孕期增重对妊娠结局的影响

The effect of overweight and obesity before pregnancy and weight gain during pregnancy on pregnancy outcomes

目的探讨孕前超重、肥胖及孕期增重对妊娠结局的影响。方法选取538例孕前超重及肥胖孕妇,根据孕妇孕前体重情况分为超重组(325例)与肥胖组(213例);再按照孕妇是否有妊娠期糖尿病(GDM)和孕期增重分亚组。各组之间比较相关临床资料及妊娠结局,分析影响妊娠结局的相关因素。结果超重组及肥胖组孕期增重、妊娠期高血压疾病发生率比较,差异有统计学意义(P<0.05);超重组GDM发生率为35.7%,肥胖组GDM发生率为39.4%。超重组内增重过度与增重适宜组比较,其妊娠期高血压疾病及巨大儿发生率比较,差异有统计学意义(P<0.05)。超重组内增重过度与增重过少孕妇中,其GDM发病率及早产儿发生率比较,差异有统计学意义(P<0.05)。结论孕前超重、肥胖及孕期增重能直接或间接影响妊娠结局,增加妊娠期糖尿病、巨大儿、妊娠期高血压疾病及早产儿发生率,关注并控制超重、肥胖及孕期增重,对改善妊娠结局极为必要。

Objective To investigate the influence of preconception overweight,obesity and pregnancy weight gain on pregnancy outcome.Methods 538 overweight and obese pregnant women were selected and divided into two groups(325 cases)and obesity group(213 cases)according to their weight before pregnancy.Women were subdivided according to whether they had gestational diabetes mellitus(GDM)and weight gain during pregnancy.The relevant clinical data and pregnancy outcome were compared among the groups,and the related factors affecting pregnancy outcome were analyzed.Results There were statistically significant differences in the incidence of pregnancy weight gain and pregnancy hypertension between the super reorganization and obesity groups(P<0.05).The incidence of super recombinant GDM was 35.7%,and the incidence of GDM in obesity group was 39.4%.There were statistically significant differences in the incidence of hypertensive disease and macrosomia between the excess weight gain group and the suitable weight gain group(P<0.05).There were statistically significant differences in the incidence of GDM and the incidence of preterm infants between pregnant women with excess weight gain and underweight gain(P<0.05).Conclusion Pre-pregnancy overweight,obesity and weight gain during pregnancy can directly or indirectly affect pregnancy outcomes,and increase the incidence of gestational diabetes,macrosomia,gestational hypertension and premature infants.It is extremely necessary to pay attention to and control overweight,obesity and weight gain during pregnancy to improve pregnancy outcomes.