妊娠不同时期孕妇体成分分析的临床价值

Clinical value of analysis of pregnancy maternal body composition in different trimester

目的探讨妊娠期孕妇体成分的变化及其与孕期体重增加值、新生儿出生体重之间的关系。方法对太原市和介休市两地区共232例健康孕妇进行前瞻性研究,分别于妊娠14~16周、24~26周、30~32周、36~38周在产前检查的基础上利用NQA-PI个体营养分析仪进行四次体成分测量,同时详细记录妊娠结局等相关资料。采用SPSS 19.0软件对数据进行统计分析,P<0.05为差异有统计学意义。结果 (1)两地区孕妇年龄、身高、孕前体重、孕期合并症和并发症发生情况及新生儿出生体重之间比较,差异无统计学意义(P>0.05)。(2)在妊娠14~16周,孕妇去脂体重(r=0.176,P<0.05)、脂肪重(r=0.157,P<0.05)、总体水(r=0.229,P<0.001)与孕期体重增加值之间呈显著正相关关系,孕妇总体水(r=0.271,P<0.05)、肌肉重(r=0.302,P<0.001)、脂肪重(r=0.198,P<0.05)、去脂体重(r=0.312,P<0.001)与新生儿出生体重之间呈显著正相关关系;在孕24~26周,细胞外液与孕期体重增加值之间呈显著正相关关系(r=0.189,P<0.05),细胞内液与孕期体重增加值之间呈显著负相关关系(r=-0.393,P<0.01),总体水(r=0.296,P<0.05)、细胞外液(r=0.265,P<0.05)、细胞内液(r=0.270,P<0.05)、肌肉重(r=0.181,P<0.05)、脂肪重(r=0.286,P<0.05)、体脂百分比(r=0.142,P<0.05)与新生儿体重间呈显著正相关关系;在孕30~32周,脂肪重(r=0.224,P<0.017)、体脂百分比(r=0.184,P<0.05)与新生儿体重间呈显著正相关关系。(3)新生儿出生体重与孕期体重增加值间呈显著正相关关系(r=0.263,P<0.05)。结论妊娠14~16周、24~26周两阶段的体成分分析结果对孕期体重增加值和新生儿体重影响较大,可利用体成分分析结果指导孕妇科学营养,合理控制孕期增重和新生儿出生体重。

Objective To research the changes of maternal body composition and the relationships among that gestational weight gain(GWG) and birth weight in the different stages of pregnancy. Methods 232 cases of healthy pregnant women in Taiyuan city and Jiexiu area were analyzed prospectively, which accepted by regular prenatal examinations and four body composition measurements in pregnancy 14-16, 24-26, 30-32, 36-38 weeks of gestation used individualized nutritional guidance and multi-frequence bioelectrical preformed by NQA-PI analyzer, meantime pregnancy outcomes of pregnant women and other relation documents were recorded. Data were analyzed by SPSS 19.0 software packet, P<0.05 was considered statistically significant. Results(1) There was not statistically significant difference between two areas of pregnancy women in maternal age, height, pre-pregnancy weight, prevalence rate of complications and pathological pregnancy, birth weight, body composition(P>0.05).(2) During the 14-16 weeks of gestation, there was significantly positive correlation among fat free mass(FFM)(r=0.176, P<0.05), body fat(BF)(r=0.157, P<0.05), total body water(TBW)(r=0.229, P<0.001) and GWG; there was significantly positive correlation among TBW(r=0.271, P<0.05), MW(r=0.302, P<0.001), BF(r=0.198, P<0.05), FFM(r=0.312, P<0.001) and birth weight. In 24-26 weeks of gestation, intracellular water(IEW)(r=-0.393, P=0.002) and extracellular water(ECW)(r=0.189, P<0.05) were significantly correlated with GWG; there was significantly negative correlation between IEW and GWG; there was significantly positive correlation among TBW(r=0.296, P<0.05), ECW(r=0.265, P<0.05), MW(r=0.181, P<0.05), BF(r=0.181, P<0.05), BF%(r=0.142, P<0.05) and birth weight. In 30-32 weeks of gestation, there was significantly positive correlation among BF(r=0.224, P<0.017), BF%(r=0.184, P<0.05) and birth weight.(3) There was significantly positive linear correlation between GWG and birth weight(r=0.263, P<0.05). Conclusions During 14-16, 24-26 weeks of gestation, maternal body composition has a great influence on GWG and birth weight. It may play an important role to control the GWG and birth weight by nutritional intervention according to the result of body composition analysis.