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目的:研究ENH三级调控系统对孕前不同体重指数孕妇体重增加及妊娠结局的影响。方法:选取2011年1月~2013年1月在青岛城区人民医院分娩的单胎初产妇,研究组纳入研究4 986例,对照组纳入研究4 990例。调查孕妇孕前或孕早期的身高、体重,计算体重指数(BMI),根据BMI分为消瘦、正常、超重、肥胖4个亚组,制订不同的营养方案,利用ENH连续三级调控模式系统分析孕妇孕期BMI增加、妊娠期并发症、母亲结局及新生儿结局。结果:研究组消瘦、正常、超重、肥胖4个亚组的平均△BMI均位于4.0~6.0 kg/m2之间,对照组平均△BMI随着孕前BMI得增长而增长。两组消瘦、超重、肥胖3个亚组的平均△BMI比较差异具有统计学意义(P<0.05)。对照组超重和肥胖人群的妊娠期糖尿病、高血压、剖宫产、产后出血、巨大儿、新生儿窒息的发病率明显高于研究组(P<0.05),而对照组消瘦者的贫血、新生儿低出生体重的发生率也明显高于研究组(P<0.05)。结论:基于ENH连续三级调控模式系统的孕妇个体化营养方案能明显降低妊娠期并发症的发生,改善母婴结局,提高人口出生质量。
OBJECTIVE: To study the effect of ENH three-stage control system on weight gain and pregnancy outcomes of pregnant women with different body mass index before pregnancy. Methods: A single-born primiparous woman delivered from January 2011 to January 2013 in Qingdao City People’s Hospital was selected. The study group included 4 986 cases and the control group 499 cases studied. The body weight and weight were calculated before and after pregnancy. The body mass index (BMI) was calculated. According to the BMI, 4 subgroups of wasting, normal, overweight and obesity were enrolled. Different nutritional plans were formulated and the ENH continuous three - BMI during pregnancy increased, complications during pregnancy, maternal outcomes and neonatal outcomes. Results: The average △ BMI of the four subgroups of wasting, normal, overweight and obesity in the study group was between 4.0 and 6.0 kg / m2. The average △ BMI in the control group increased with the increase of BMI before pregnancy. The average △ BMI of three groups of weight loss, overweight and obesity in two groups had statistical significance (P <0.05). The incidence of gestational diabetes mellitus, hypertension, cesarean section, postpartum hemorrhage, macrosomia and neonatal asphyxia in the overweight and obese population of the control group was significantly higher than that of the study group (P <0.05), but the anemia and nascent The incidence of low birth weight was also significantly higher in the study group (P <0.05). Conclusion: The individualized nutrition plan for pregnant women based on ENH continuous three-level control mode system can significantly reduce the incidence of complications during pregnancy, improve maternal and infant outcomes and improve the birth quality of the population.