目的：探讨产前预测新生儿出生体重的方法，为降低产时并发症（产后出血、软产道裂伤、生殖道瘘、肩难产、新生儿窒息）提供科学依据。方法：根据孕前体重指数（Body Mass Index，BMI）将研究对象分为高体重组、标准体重组、低体重组。...目的：探讨产前预测新生儿出生体重的方法，为降低产时并发症（产后出血、软产道裂伤、生殖道瘘、肩难产、新生儿窒息）提供科学依据。方法：根据孕前体重指数（Body Mass Index，BMI）将研究对象分为高体重组、标准体重组、低体重组。孕期增重〉18kg，定为高增重组；孕期增重9—18kg，定为标准增重组；孕期增重〈9kg，定为低增重组。分别计算各组新生儿平均体重、巨大儿发生率、低体重儿发生率。应用超声测量胎儿腹围（Fetal Abdominal Circumference，FAC），分析胎儿腹围与新生儿出生体重的关系。结果：各组新生儿平均体重、巨大儿发生率、低体重儿发生率均有差异，差异有统计学意义。FAC≥36cm时，巨大儿发生率83．33％，明显高于非巨大儿发生率，差异有统计学意义。多因素逐步回归分析新生儿出生体重与孕前BMI最相关，与孕期增重、FAC也相关，得出预测新生儿体重的回归方程式：新生儿出生体重=106．204＋90．999X孕前BMI＋31．756X孕期增重＋27．613×FAC。预测巨大JI,I~H性率91．84％，剖宫产率77．55％。556例孕妇中无1例产时并发症。结论：联合应用超声测量、孕妇孕前体重指数（BMI）及孕期增重预测新生儿出生体重的方法值得推广应用。展开更多
To evaluate the effects of maternal pre-pregnancy body mass index （pre-BMI） and gestational weight gain （GWG） on neonatal birth weight （NBW） in the population of Chinese healthy pregnant women, attempting to gui...To evaluate the effects of maternal pre-pregnancy body mass index （pre-BMI） and gestational weight gain （GWG） on neonatal birth weight （NBW） in the population of Chinese healthy pregnant women, attempting to guide weight control in pregnancy. A retrospective cohort study of 3772 Chinese women was conducted. The population was stratified by maternal pre-BMI categories as underweight （〈18.5 kg/m2）, normal weight （18.5-23.9 kg/m2）, overweight （24.0-27.9 kg/m2）, and obesity （〉28.0 kg/m2）. The NBW differences were tested among the four groups, and then deeper associations among maternal pre-BMI, GWG, and NBW were investigated by multivariate analysis. NBW increased significantly with the increase of maternal pre-BMI level （P〈0.05）, except overweight to obesity （P〉0.05）. The multivariate analysis showed that both pre-BMI and GWG were positively correlated with NBW （P〈0.05）. Compared with normal pre-BMI, underweight predicted an increased odds ratio of small-for-gestational-age （SGA） and decreased odds ratio for macrosomia and large-for-gestational-age （LGA）, and the results were opposite for overweight. With the increase of GWG, the risk of SGA decreased and the risks of macrosomia and LGA increased. In addition, in different pre-BMI categories, the effects of weight gain in the first trimester on NBW were different （P〈0.05）. NBW is positively affected by both maternal pre-BMI and GWG, extreme pre-BMI and GWG are both associated with increased risks of abnormal birth weight, and maternal pre-BMI may modify the effect of weight gain in each trimester on NBW. A valid GWG guideline for Chinese women is an urgent requirement, whereas existing recommendations seem to be not very suitable for the Chinese.展开更多
文摘目的：探讨产前预测新生儿出生体重的方法，为降低产时并发症（产后出血、软产道裂伤、生殖道瘘、肩难产、新生儿窒息）提供科学依据。方法：根据孕前体重指数（Body Mass Index，BMI）将研究对象分为高体重组、标准体重组、低体重组。孕期增重〉18kg，定为高增重组；孕期增重9—18kg，定为标准增重组；孕期增重〈9kg，定为低增重组。分别计算各组新生儿平均体重、巨大儿发生率、低体重儿发生率。应用超声测量胎儿腹围（Fetal Abdominal Circumference，FAC），分析胎儿腹围与新生儿出生体重的关系。结果：各组新生儿平均体重、巨大儿发生率、低体重儿发生率均有差异，差异有统计学意义。FAC≥36cm时，巨大儿发生率83．33％，明显高于非巨大儿发生率，差异有统计学意义。多因素逐步回归分析新生儿出生体重与孕前BMI最相关，与孕期增重、FAC也相关，得出预测新生儿体重的回归方程式：新生儿出生体重=106．204＋90．999X孕前BMI＋31．756X孕期增重＋27．613×FAC。预测巨大JI,I~H性率91．84％，剖宫产率77．55％。556例孕妇中无1例产时并发症。结论：联合应用超声测量、孕妇孕前体重指数（BMI）及孕期增重预测新生儿出生体重的方法值得推广应用。
基金Project supported by the National Natural Science Foundation of China(Nos.81370725 and 81370726)the Natural Science Foundation of Zhejiang Province(No.LQ14H040004)the Key Discipline of Obstetrics of Zhejiang Province,China
文摘To evaluate the effects of maternal pre-pregnancy body mass index （pre-BMI） and gestational weight gain （GWG） on neonatal birth weight （NBW） in the population of Chinese healthy pregnant women, attempting to guide weight control in pregnancy. A retrospective cohort study of 3772 Chinese women was conducted. The population was stratified by maternal pre-BMI categories as underweight （〈18.5 kg/m2）, normal weight （18.5-23.9 kg/m2）, overweight （24.0-27.9 kg/m2）, and obesity （〉28.0 kg/m2）. The NBW differences were tested among the four groups, and then deeper associations among maternal pre-BMI, GWG, and NBW were investigated by multivariate analysis. NBW increased significantly with the increase of maternal pre-BMI level （P〈0.05）, except overweight to obesity （P〉0.05）. The multivariate analysis showed that both pre-BMI and GWG were positively correlated with NBW （P〈0.05）. Compared with normal pre-BMI, underweight predicted an increased odds ratio of small-for-gestational-age （SGA） and decreased odds ratio for macrosomia and large-for-gestational-age （LGA）, and the results were opposite for overweight. With the increase of GWG, the risk of SGA decreased and the risks of macrosomia and LGA increased. In addition, in different pre-BMI categories, the effects of weight gain in the first trimester on NBW were different （P〈0.05）. NBW is positively affected by both maternal pre-BMI and GWG, extreme pre-BMI and GWG are both associated with increased risks of abnormal birth weight, and maternal pre-BMI may modify the effect of weight gain in each trimester on NBW. A valid GWG guideline for Chinese women is an urgent requirement, whereas existing recommendations seem to be not very suitable for the Chinese.
