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目的:探讨初次妊娠妇女待孕前体重指数对妊娠结局的影响。方法:采用回顾性群组研究方法,对2000～2006年间,在牡丹江中医院产前门诊就诊并在其院部分娩单胎的839名初次妊娠的育龄妇女进行了研究。这些妇女按体重指数分成五组:偏轻组(BMI<18.5kg/m2)、正常组(BMI=18.5～23.9kg/m2)、超重组(BMI=24～27.9kg/m2)、肥胖组(BMI=28～31.9kg/m2)、和病态肥胖组(BMI≥32kg/m2)。使用单变量和多变量分析对比各组对妊娠结局的影响。结果:和正常组妇女相比,病态肥胖组妇女患妊娠高血压疾病{OR4.37(95%CI1.32,14.41)}和妊娠期糖尿病{OR6.01(95%CI1.95,18.52)}的风险极高,而体重偏轻组妇女的患病风险最低。病态肥胖组妇女引产几率最高{OR2.94(95%CI1.02,8.48)},体重偏轻组妇女引产几率最低。病态肥胖组妇女剖腹产几率最高{OR3.22(95%CI1.13,9.22)},体重偏轻组妇女剖腹产几率最低。病态肥胖组妇女更容易患产后出血症{OR4.05(95%CI1.08,15.20)}和早产{OR5.55(95%CI1.14,27.15)}。病态肥胖组妇女分娩巨大儿的风险最高{OR5.55(95%CI1.14,27.15)},而体重偏轻组妇女风险最低。体重偏轻组妇女分娩低体重儿的风险最高{OR5.14(95%CI1.26,20.92)}。结论:孕妇体重指数的增加相应带来妊娠期高血压疾病、妊娠期糖尿病、巨大儿、引产、剖腹产发生率的增加。与拥有正常体重指数的妇女相比,体重偏轻的妇女有比较好的妊娠结局。
Objective: To investigate the effect of body mass index of pregnant women before pregnancy on pregnancy outcomes. Methods: A retrospective cohort study was conducted in 839 pregnant women of childbearing age who visited the prenatal clinic of Mudanjiang Hospital of Chinese Medicine during the period from 2000 to 2006 and gave birth to a single fetus in their hospital. The women were divided into five groups according to body mass index: partial light group (BMI <18.5kg / m2), normal group (BMI = 18.5-23.9kg / m2), overweight group (BMI = 24-27.9kg / m2) BMI = 28 ~ 31.9kg / m2), and morbidly obese group (BMI≥32kg / m2). Univariate and multivariate analyzes were used to compare the effect of each group on pregnancy outcomes. Results: Women with morbidly obese group had a higher prevalence of pregnancy-induced hypertension (OR 4.37 (95% CI 1.32, 14.41)} and gestational diabetes {OR 6 0.01 (95% CI 1.95, 18.52) The risk is extremely high, while in overweight women, the risk is the lowest. Women in the morbidly obese group had the highest rate of induction of labor {OR2.94 (95% CI 1.02, 8.48)}, while women in the underweight group had the lowest rate of induction of labor. Women in the morbidly obese group had the highest risk of caesarean section {OR3.22 (95% CI 1.13, 9.22)}, while women in the underweight group had the lowest rates of caesarean section. Women in the morbidly obese group were more likely to develop postpartum haemorrhage {OR 4.05 (95% CI 1.08, 15.20)} and preterm {OR 5.55 (95% CI 1. 14, 27.15)}. Women in the morbidly obese group had the highest risk of giving birth to large children {OR 5.55 (95% CI 1.14, 27.15)}, while women in the underweight group had the lowest risk. Women with low birth weight had the highest risk of giving birth to low birth weight children {OR 5.14 (95% CI 1.26, 20.92)}. Conclusion: The increase of body mass index in pregnant women has correspondingly increased the incidence of hypertensive disorder complicating pregnancy, gestational diabetes mellitus, giant child, induction of labor and cesarean section. Compared with women with normal body mass index, overweight women have better pregnancy outcomes.