孕期体重管理联合产时无创接生对妊娠结局的影响

Impacts of body mass management in pregnancy combined with non-invasive delivery at birth on gestational outcomes

目的:研究孕期体重管理联合无创接生对产妇妊娠结局的影响。方法:临床纳入94例2015年12月至2017年6月期间进行产检的孕妇作为研究对象。根据随机排列表法分为两组各47例。其中47例孕妇给予系统常规产检以及营养教育;另47例患者在上述基础上给予孕期体重管理。两组孕妇均符合无创接生要求。观察两组孕妇孕期体质量增加情况、新生儿体质量情况、总产程时间、产后出血量、会阴损伤情况、妊娠结局及相关并发症情况。结果:观察组低体重、正常体重、超重以及肥胖患者体质量增长均低于对照组孕妇,观察组新生儿体重低于对照组(P<0.05)。观察组总产程时间及产后出血量均少于对照组(P<0.05)。观察组Ⅰ度裂伤、Ⅱ度裂伤比例均低于对照组(P<0.05)。观察组妊娠结局如巨大儿、新生儿窒息及妊娠并发症如妊娠期糖尿病、妊娠期高血压等发生率均低于对照组(均P<0.05)。结论:孕期体重管理联合无创接生可有效缩短产程,减轻会阴损伤,降低妊娠期并发症,改善妊娠结局,值得临床应用及推广。

Objective: To investigate the impacts of body mass management in pregnancy combined with non-invasive delivery at birth on maternal gestational outcomes. Methods: A total of 94 pregnant women who underwent antenatal examination between December 2015 and June 2017 were included in this study,and were divided into two groups( n = 47 each) by random number table. Among them,47 pregnant women received conventional antenatal examination and nutrition education( control group), while the other 47 patients underwent body mass management during the pregnancy( study group). All pregnant women in the both groups were eligible for non-invasive delivery. The increase in maternal body mass index during pregnancy,neonatal body mass index,gestational time,postpartum hemorrhage,perineal injury,gestational outcome and related complications were recorded. Results: The increases in body mass index among low-weighted,normal-weighted,overweighted and obese women in the study group were lower than those in the control group;the neonatal body weight in the study group was lower than that in the control group( P< 0.05). The study group also experienced shorter total labor time and less postpartum hemorrhage compared with the control group( P < 0. 05). The proportion of degrees I and II laceration in the study group was lower than that in the control group( P < 0.05).The incidence rate of gestational outcomes( macrosomia and neonatal asphyxia) and related complications( gestational diabetes,gestational hypertension) were lower in the study group than in the control group( P<0.05). Conclusion: Body mass management in pregnancy combined with non-invasive delivery at birth may effectively shorten the labor process,reduce perineal injury and gestation-related complications,and also improve the gestational outcomes. Therefore it is worthwhile for widespread use in clinical settings.