单胎子痫前期孕妇产前体质量指数与母婴结局关系探讨

Relationship between prenatal body mass index and pregnancy outcomes in singleton pregnant women with preeclampsia

目的 探讨不同产前体质量指数(BMI)单胎子痫前期孕妇的临床特征和母婴结局,分析产前BMI作为不良母婴结局风险因素的相对危险度。方法 回顾性分析2016年1月至2021年12月间于南方医院分娩的479例确诊子痫前期的单胎孕妇临床资料,根据产前BMI分为A组(BMI <26 kg/m~2)、B组(26≤BMI <28 kg/m~2)、C组(28≤BMI <30 kg/m~2)、D组(30≤BMI <32 kg/m~2)、E组(BMI≥32 kg/m~2),比较患者一般情况、妊娠情况及母婴结局。结果 各组患者相比,A组患者发生重度子痫前期、胎盘早剥、胎儿生长受限、新生儿NICU转入比例升高,终止妊娠时间更早;E组患者剖宫产分娩、妊娠期糖尿病、巨大儿比例升高,且术中及产后24 h出血量更大;C组患者具有最低的引产/死胎比例。相较于C组,BMI≥32 kg/m~2是发生妊娠期糖尿病的危险因素;BMI <26 kg/m~2是胎盘早剥、胎儿生长受限的危险因素;BMI<26 kg/m~2或BMI≥30 kg/m~2是新生儿NICU转入的危险因素。结论 子痫前期患者产前BMI与不良母婴结局有关,患者产前BMI的适宜范围为26~30 kg/m~2。

Objective To explore the clinical characteristics and pregnancy outcomes of singleton preg-nant women with preeclampsia and with different prenatal body mass index(BMI),and analyze the relative risk of prenatal BMI as a risk factor for adverse outcomes.Methods A retrospective analysis was conducted on the clini-cal data of 479 singleton pregnant women with preeclampsia that delivered in Nanfang Hospital from January 2016 to December 2021.They were divided into group A(BMI<26 kg/m2),group B(26≤BMI<28 kg/m2),group C(28≤BMI<30 kg/m2),group D(30≤BMI<32 kg/m2),and group E(BMI≥32 kg/m2)according to prenatal BMI.The general situation,pregnancy complications and pregnancy outcomes in each group were compared.Results The proportion of adverse outcomes such as severe preeclampsia,placental abruption,fetal growth restriction,and NICU transfer ratio in group A was increased,and these patients terminated pregnancy earlier.In group E,the proportion of cesarean delivery,gestational diabetes and macrosomia was increased,and there was more blood loss during operation and 24 hours after delivery.Patients of Group C had the lowest proportion of induced abortion or stillbirth.Compared with group C,BMI≥32 kg/m2 was a risk factor for gestational diabetes;BMI<26 kg/m2 was a risk factor for placental abruption and fetal growth restriction,while BMI<26 kg/m2 or BMI≥30 kg/m2 was the risk factor for the neonatals′NICU admission.Conclusion There is correlation between prenatal BMI and adverse pregnancy outcomes in pregnant women with preeclampsia,and the appropriate range of BMI is 26~30 kg/m2.