孕妇孕期体重指数变化与妊娠结局的相关性研究

Relationship Between Body Mass Index and Pregnancy Outcome in Pregnant Women

目的:探讨孕妇孕前体重指数(BMI)、孕期体重增重现状与妊娠结局的关系,为孕期体重管理提供科学依据。方法:选择2013年5月至2015年2月我院产科住院分娩的初产妇457例作为研究对象。收集研究对象的一般资料,按照标准进行孕前体重指数分组,孕期增重分组,比较不同组别妊娠结局的差异。结果:457名孕妇孕前超重与肥胖有177人(38.73%),孕期增重过多120人(26.26%);平均年龄(26.99±5.89)岁,平均孕周为(39.27±1.43)周,不同孕前体重指数分组的孕妇年龄、孕周差异无统计学意义,P>0.05;肥胖组的妊娠期高血压综合征发生率(15.79%)、巨大儿发生率(14.04%)最高,体重过低组的低出生体重儿发生率(8.33%)最高,不同孕前BMI孕妇妊娠期高血压综合征、巨大儿、低出生体重儿发生率差异具有统计学意义,P<0.05;增重过多组妊娠期高血压综合征发生率(16.28%)、巨大儿发生率(10.85%)、剖宫产发生率(20.16%)最高,增重不足组低出生体重儿发生率最高(6.20%),不同孕期增重孕妇妊娠期高血压综合征、巨大儿、低出生体重儿、剖宫产发生率差异具有统计学意义,P<0.05。结论:孕前及孕期体重与妊娠结局密切相关,控制孕前体重、孕期体重增重在合理的范围内,对减少不良妊娠有着重要的意义。

Objective:To investigate the effect of pre-pregnancy body mass index(BMI)and materbal weight gain on pregnancy outcome,which will provide a scientific basis for pregnancy weight management.Methods:The data of 457 cases were collected from Hubei Maternity and Child Hospital from May 2013 to February 2015.We collected the general information of research object.All of the cases were divided into four groups according to pre-pregnancy BMI(kg/m2):low wight group(BMI<18.5),normal weight group(18.5≤BMI≤23.9),overweight group(24.0≤BMI≤27.9),and obese group(BMI≥28);and also were divided into three groups according to different increment of body weight during pregnancy:low weight gain group,norml weight gain group,and high weight gain group.Results:There were 177women(38.73%)had overweight and obesity,120women(26.26%)had high weight gain during pregnancy.The mean of matenal age was(26.99±5.89)years old and the average gestational age was(39.27±1.43)weeks.The different pregnancy body mass index group had no statistically significant difference in age and pregnant weeks(P>0.05).Gestational hypertension syndrome and macrosomia were most com-mon in obesity group as 15.79%and 14.04%respectively.While low birth weight was most frequent in low body weight group as 8.33%.The incidence of gestational hypertension syndrome,macrosomia,low birth weight between different BMI groups had statistically significant difference(P<0.05).The incidences of gestational hypertension syndrome,macrosomia,and cesarean section were the highest in high weight gain group as 16.28%,10.85%,and 20.16% respectively.The low weight gain group had the highest incidence of low birth weight as 6.20%.That different weight gain during pregnancy had a pregnancy statistically significant rate difference in hypertension syndrome,macrosomia,low birth weight,and cesarean section(P<0.05).Conclusion:BMI before pregnancy and pregnancy weight gain are closely related to the pregnancy outcome.Control of the pregnancy body weight within a reasonable range is of great significance to the reduction of adverse pregnancy.