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目的探讨孕前体质量指数(BMI)与孕期体质量增长对妊娠结局的影响。方法将2015-2016年在桂林市妇幼保健院产检、单胎足月分娩的5 000例产妇作为研究对象,根据孕前BMI分为4组:BMI<18.5 kg/m~2设为低体质量组872例,BMI 18.5~24 kg/m~2设为正常体质量组3 196例,BMI 25~28 kg/m~2设为超重组671例,BMI>28 kg/m~2设为肥胖组261例。结果(1)孕前体质量:孕前肥胖组的子痫前期、妊娠期糖尿病(GDM)、剖宫产率、早产儿及大于胎龄儿(LGA)发生率均高于低体质量组和正常体质量组(P<0.05);小于胎龄儿(SGA)发生率孕前低体质量组高于正常体质量组(P<0.05)。(2)孕期体质量指数(BMI)增幅:子痫前期、GDM、剖宫产率、LGA发生率孕期BMI增幅>6 kg/m~2均高于增幅为4~6 kg/m~2及<4 kg/m~2者,差异有统计学意义(P<0.05),增幅4~6 kg/m~2者剖宫产率高于增幅<4 kg/m~2者,差异有统计学意义(P<0.05);增幅<4 kg/m~2者的SGA发生率高于增幅>4~6 kg/m~2及>6 kg/m~2者,差异有统计学意义(P<0.05)。结论孕前BMI与孕期体质量增长幅度影响妊娠结局,合理的孕前BMI与孕期体质量增幅可获得良好的妊娠结局。
Objective To investigate the effect of pre-pregnancy body mass index (BMI) and pregnancy weight gain on pregnancy outcome. Methods A total of 5 000 pregnant women who were born at Guilin Maternal and Child Health Hospital from 2015 to 2016 were enrolled in this study. Five pregnant women with full-term single childbirth were divided into 4 groups according to BMI before pregnancy: BMI <18.5 kg / m ~ 2 872 cases and BMI 18.5-24 kg / m ~ 2 were set as 3 196 cases of normal body mass. BMI 25-28 kg / m 2 was set as 671 cases of overweight group and BMI> 28 kg / m 2 as obesity group 261 cases. Results (1) Pre-pregnancy weight: The incidence of preeclampsia, gestational diabetes mellitus (GDM), cesarean section rate, preterm infants and LGA were significantly higher in the pre-pregnancy obese group than in the low-weight group and the normal (P <0.05). The incidence of small gestational age (SGA) in pre-pregnancy low-body weight group was higher than that in normal body weight group (P <0.05). (2) The increase of BMI during pregnancy: preeclampsia, GDM, cesarean section rate and LGA incidence rate of pregnancy BMI increase> 6 kg / m ~ 2 were higher than the increase rate of 4 ~ 6 kg / m ~ 2 and <4 kg / m ~ 2, the difference was statistically significant (P <0.05), an increase of 4 ~ 6 kg / m ~ 2 cesarean section rate was higher than the increase <4 kg / m ~ 2, the difference was statistically significant (P <0.05). The incidence of SGA in the range of <4 kg / m 2 was higher than that in the range of> 4-6 kg / m 2 and> 6 kg / m 2 (P < 0.05). Conclusion The pre-pregnancy BMI and the growth rate during pregnancy affect the outcome of pregnancy. Reasonable pre-pregnancy BMI and body mass gain during pregnancy can achieve good pregnancy outcomes.