单胎妊娠孕妇妊娠期体重增长影响因素及护理对策

Influencing factors of the gestational weight gain for singleton pregnant women and nursing countermeasures

目的了解单胎妊娠孕妇妊娠期体重增长现状并分析其影响因素,为开展妊娠期体重管理提供参考。方法采用便利抽样法,选择2020年6月—10月在上海市某三级甲等妇产专科医院产科门诊建卡、产检并计划在该机构分娩的393名孕妇作为调查对象。采用一般资料调查表、孕期生殖健康素养问卷、分娩自我效能量表进行调查,分析单胎妊娠孕妇妊娠期体重增长的影响因素。结果393名单胎妊娠孕妇妊娠期体重增长(13.66±6.10)kg,增重不足、适宜和过多的比例分别占35.6%、32.3%和32.1%。Logistic回归分析结果显示,文化程度、既往疾病史、孕前体重指数情况、孕期是否参加助产士门诊是单胎妊娠孕妇妊娠期体重增长的影响因素(P<0.05)。结论单胎妊娠孕妇妊娠期体重增长异常比例较高,硕士及以上学历、有既往疾病史、孕前体重指数正常、孕期参加助产士门诊的孕妇发生妊娠期体重增长异常的风险较低。产科护理人员应进一步重视妊娠期体重管理,充分发挥助产士门诊作用并开展相关健康教育和咨询指导,以促进孕妇妊娠期适宜体重增长,改善母婴健康结局。

Objective To explore the current situation and influencing factors of gestational weight gain for singleton pregnant women.Methods From June to October 2020,a total of 393 pregnant women who had registered for antenatal checkups at an obstetric clinic of a tertiary obstetrics and gynecology hospital in Shanghai and planned to give birth at the same hospital were selected through convenience sampling.The General Information Questionnaire,Pregnancy Health Literacy Questionnaire and Childbirth Self-Efficacy Questionnaire were used to collect data.Multivariate logistic regression analysis was used to analyze the influencing factors of weight gain during pregnancy.Results A total of 393 women were included in the analysis.Participants’average gestational weight gain was(13.66±6.10)kg.The proportion of women with inadequate,appropriate and excessive gestational weight gain were 35.6%,32.3%and 32.1%,respectively.Logistic regression analysis showed that the influencing factors for gestational weight gain included education background,previous medical history,pre-pregnancy body mass index,and attending midwife’s clinic(P<0.05).Conclusion The proportion of abnormal gestational weight gain was relatively high among singleton pregnant women.Those who had a master degree or above,a previous medical history,a normal pre-pregnancy body mass index,and attended midwife’s clinic during pregnancy were at lower risks of abnormal gestational weight gain.Obstetric nurses should pay more attention to gestational weight management,giving full play to midwife’s antenatal clinic,and implementing health education and counseling related to gestational weight management,in order to promote appropriate gestational weight gain and to improve maternal-fetal outcomes.