孕前体质量指数和妊娠期体质量增长对新生儿出生体质量及不良结局的研究

Association of pre-pregnancy body mass index and gestational weight gain and neonatal birth weight and adverse outcomes

目的 探讨孕前体质量指数及妊娠期体质量增长对新生儿出生体质量及不良结局的影响。方法 选取溧水区人民医院1510例孕母及婴儿作为研究对象。采用多重线性回归分析孕前体质量指数及妊娠期体质量增长与新生儿出生体质量的关联关系,采用多因素Logistic回归分析探讨孕前体质量指数及妊娠期体质量增长与新生儿出生不良结果发生风险的关联关系。结果 孕前低体质量、超重、肥胖女性的发生率8.87%、18.08%、8.68%;随着孕前体质量指数的增加,新生儿出生体质量呈增加趋势;超重及肥胖女性,发生巨大儿及大于胎龄儿的风险增加;整体上,妊娠期体质量增长不足时新生儿出生体质量低,体质量增长过多时新生儿出生体质量高、发生巨大儿及大于胎龄儿的风险增加;不同的孕前体质量指数,当妊娠期体质量增长不同时,新生儿的出生体质量及不良结局亦不同。结论 孕前超重及肥胖增加了新生儿发生巨大儿及大于胎龄儿不良结局的风险,不同孕前体质量指数因妊娠期体质量增长不同、新生儿的出生体质量及不良结局不同。根据孕前体质量指数制定个体化的营养方案,有助于减少新生儿不良结局的可能性。

Objective To investigate the effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight and adverse outcomes.Methods A total of 1510 pregnant women and infants in Lishui People’s Hospital were selected as research subjects.Multiple linear regression was used to analyze the association between pre-pregnancy and gestational weight gain and neonatal birth weight,and multivariate Logistic regression was used to explore the association of pre-pregnancy body mass index and gestational weight gain with the risk of neonatal adverse outcomes.Results The incidence of underweight,overweight and obesity before pregnancy was 8.87%,18.08%and 8.68%,respectively.With the increase of pre-pregnancy body mass index,the birth weight showed an increasing trend.Overweight and obese pregnant women had an increased risk of macrosomia and infants large for gestational age.Overall,when the gestational weight gain was insufficient,the birth weight was low.When the weight gain was excessive,the birth weight was high,and the risk of macrosomia and infants large for gestational age increased.When the pre-pregnancy body index was different,neonatal birth weight and adverse outcomes were also different and varied with gestational weight gain.Conclusion Pre-pregnancy overweight and obesity increase the risk of adverse outcomes of macrosomia and large for gestational age.Neonatal birth weight and adverse outcomes varied with gestational weight gain when pre-pregnancy body mass index varies.An individualized nutrition program based on the pre-pregnancy body mass index can help reduce the likelihood of adverse neonatal outcomes.