孕前不同体质量指数及孕期体重不同增加量与子痫前期产妇妊娠结局的关系

Relationship between progestational body mass index,gestational weight gain and pregnancy outcomes in puerperae with preeclampsia

目的:探讨孕前不同体质量指数(BMI)及孕期体重不同增加量(GWG)与子痫前期(PE)产妇妊娠结局的关系。方法:选取160例收治的PE产妇作为PE组;同期60例健康体检孕妇作为对照组。PE组产妇再根据病情分为轻度组(MPE组,n=65)和重度组(SPE组,n=95);根据BMI分为超重肥胖组(n=15)、正常体重组(n=107)及低体重组(n=38);根据GWG分为增长过多组(EGWG组,n=91)、增长适宜组(AGWG组,n=47)及增长过少组(IGWG组,n=22)。比较PE组与对照组及不同病情PE组一般资料、孕前BMI、孕期GWG,分析孕前BMI、孕期GWG与PE产妇妊娠结局的关系。结果:PE组和对照组年龄、孕前BMI、孕期GWG、妊娠期糖尿病、高血压家族史有统计学差异(P<0.05);不同病情PE组患者孕前BMI、孕期GWG、妊娠期糖尿病、高血压家族史差异有统计学意义(P<0.05)。超重肥胖组和低体重组不良妊娠结局的总发生率高于正常体重组(P<0.05)。妊娠EGWG组和IGWG组不良妊娠结局的总发生率高于妊娠AGWG组(P<0.05)。相关性分析显示,孕前BMI、孕期GWG与PE妊娠结局均呈正相关关系(P<0.05)。结论:孕前BMI、孕期GWG与PE发生密切相关,且孕前超重肥胖、低体重、EGWG、IGWG均与PE患者不良妊娠结局密切相关。

Objective:To explore the relationship between progestational body mass index(BMI),gestational weight gain(GWG)and pregnancy outcomes in puerperae with preeclampsia(PE).Methods:A total of 160 puerperae with PE and 60 healthy puerperae were retrospectively enrolled as PE group and control group.The parturients of the PE group were further divided into mild group(MPE group,n=65)and severe group(SPE group,n=95)based on their condition,divided into overweight and obesity group(n=15),normal weight group(n=107),and low body weight group(n=38)based on BMI.According to GWG,they were divided into an excessive growth group(EGWG group,n=91),an appropriate growth group(AGWG group,n=47),and an insufficient growth group(IGWG group,n=22).The clinical data,progestational BMI and gestational GWG were compared between the PE group and the control group,as well as the PE group with different severe conditions.The relationship between progestational BMI,gestational GWG and pregnancy outcomes in PE puerperae was analyzed.Results:There were significant differences between PE group and control group in age,progestational BMI,gestational GWG,diabetes during pregnancy,and family history of hypertension(P<0.05).There were significant differences in progestational BMI,gestational GWG,diabetes during pregnancy,and family history of hypertension among PE patients with different conditions(P<0.05).The total incidence of adverse pregnancy outcomes in overweight and obesity group and low weight group was higher than that in normal weight group(P<0.05),and the total incidence in excessive gestational weight gain group and inadequate gestational weight gain group was higher than that in adequate gestational weight gain group(P<0.05).Spearman correlation analysis showed that progestational BMI and gestational GWG were positively correlated with pregnancy outcomes in PE(P<0.05).Conclusion:Progestational BMI and gestational GWG will increase the risk of PE.Prepregnancy overweight obesity/low weight,EGWG/IGWG are correlated with adverse pregnancy outcomes in PE patients.