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目的探讨孕妇孕前体质指数(BMI)和孕期增重对新生儿出生体重的影响。方法收集2001—2015年在舟山市妇幼保健院围产保健监测系统登记建册的40 931名孕产妇及其单胎活产儿的临床资料,采用无序多分类Logistic回归模型分析孕前BMI和孕期增重与新生儿出生体重的关系。结果孕期增重正常17 143人,占41.92%,孕期增重过多12 409人,占36.56%,孕期增重过少8 799人,占21.52%;适于胎龄儿(AGA)34 295人,占83.87%,小于胎龄儿(SGA)3 322人,占8.12%,大于胎龄儿(LGA)3 276人,占8.01%。孕妇年龄、身高、体重和孕期增重在SGA、AGA、LGA组依次增加(均P<0.05),三组孕妇孕前BMI差异有统计学意义(P<0.01),而吸烟、饮酒和民族情况差异无统计学意义(均P>0.05)。体重过轻的孕妇增重过多不会增加分娩SGA的风险(OR=0.95,95%CI:0.78~1.41),且不管增重多少,其分娩LGA的风险均较低。超重或肥胖的孕妇增重过少和增重正常均不会增加分娩SGA的风险(OR=0.95、1.02,均P>0.05),但不管增重多少均会增加分娩LGA的风险(OR=1.79、2.50、3.11,均P<0.05)。结论孕妇年龄、孕前BMI和孕期增重是新生儿出生体重的重要影响因素,建议加强孕产妇健康教育。
Objective To investigate the effects of pre-pregnancy body mass index (BMI) and pregnancy weight gain on newborn birth weight. Methods The clinical data of 40 931 pregnant women and their single live births registered in the Perinatal Health Monitoring System of Zhoushan Maternal and Child Health Hospital from 2001 to 2015 were collected. The disorganized Logistic regression model was used to analyze the changes of pre-pregnancy BMI and gestational age Relationship between weight and newborn birth weight. Results The weight gain during pregnancy was 17 143, accounting for 41.92%. There were 12 409 people who were overweight in pregnancy, accounting for 36.56%, 8 799 people underweight during pregnancy, accounting for 21.52%, 34 295 for gestational age (AGA) , Accounting for 83.87%, 3 322 less than gestational age (SGA), accounting for 8.12%, 3 276 more than gestational age (LGA), accounting for 8.01%. Pregnancy women’s age, height, weight and weight gain during pregnancy were increased in order of SGA, AGA and LGA groups (all P <0.05). There were significant differences in BMI before pregnancy between the three groups (P <0.01), but smoking, alcohol consumption and ethnic differences No statistical significance (all P> 0.05). An overweight pregnant woman who is underweight does not increase the risk of delivering SGA (OR = 0.95, 95% CI: 0.78 to 1.41), and is at a lower risk of delivering LGA regardless of weight gain. Overexpression or obesity in pregnant women with underweight and normal weight gain did not increase the risk of delivery of SGA (OR = 0.95, 1.02, all P> 0.05), but increased the risk of LGA (OR = 1.79 , 2.50,3.11, all P <0.05). Conclusion The age of pregnant women, pre-pregnancy BMI and weight gain during pregnancy are important influencing factors of newborn birth weight. It is suggested to strengthen maternal health education.