«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

期数:

2014年07期

页码:

529-531

栏目:

论著

出版日期:

2014-08-31

文章信息/Info

Title:

Relationship of progestation body mass index and gestational weight gain and pregnancy outcomes among rural pregnant women

作者:

李春荣¹;  肖琼英²;  杜晓蓉³;  孔金旺¹

1.成都市妇女儿童中心医院，四川成都610091；2.成都市金堂县第二人民医院，四川成都610400； 3.绵阳市第二人民医院，四川绵阳621000

Author(s):

LI Chun-rong*;  XIAO Qiong-ying;  DU Xiao-rong;  KONG Jin-wang

*Chengdu Women's and Children's Central Hospital，Chengdu ,Sichuan 610091, China Corresponding author:LI Chun-rong,E-mail:cdlcr@163.com

关键词:

妊娠; 体质指数; 孕期增重; 妊娠结局

Keywords:

Obesity;  Body mass index (BMI);  Gestational weight gain;  Pregnancy outcomes

分类号:

R737.33

DOI:

-

摘要:

目的探讨农村孕妇孕前体质指数(BMI)及孕期增重对妊娠结局的影响，为有针对性地制定孕期体质 量管理提供理论依据。方法采用回顾性研究的方法，对658 例足月单胎初产妇身高、体重及孕期体重增 长情况进行整理，计算BMI；根据妊娠前BMI 值分为BMI<25.0 kg/m2 及BMI≥25.0 kg/m2 2 组；按照妊 娠期体质量增加情况，分为妊娠期体质量增加≥15 kg 及妊娠期体质量增加<15 kg 2 组。比较各组妊娠期 糖尿病、妊娠高血压疾病、产褥感染、产后出血、会阴裂伤、产程异常、剖宫产、新生儿体重(≥4 000 g) 间差异。采用PASW Statistics 18.0 进行统计学分析。结果孕前BMI≥25.0 kg/m2 能显著增加妊娠期糖 尿病（RR=3.80，95%CI 2.36~6.12），妊娠高血压疾病（RR=3.50，95%CI 2.15~5.72），产褥感染（RR= 7.48，95%CI 2.49~22.44），产程异常（RR=4.79，95%CI 3.77~6.09），剖宫产（RR=1.81，95%CI 1.65~ 1.97） 以及新生儿体重≥4 000 g （RR=5.14， 95%CI=2.90~9.10） 的发生率， P 均<0.01。孕期体质量增 加≥15.0 kg 能显著增加妊娠期糖尿病（RR=3.56，95%CI 1.96~6.47），妊娠高血压疾病（RR=1.79，95% CI 1.06~3.01）， 产褥感染（RR=4.41， 95% CI 1.31~14.88）， 产程异常（RR=2.52， 95% CI 1.93~3.30）， 以及新生儿体重≥4 000 g （RR=2.80， 95%CI 1.52~5.17） 的发生率， P 均<0.05。结论孕前BMI≥ 25.0 kg/m2 以及孕期体重增加≥15.0 kg 会增加孕期并发症的发生率以及增加不良妊娠结局的发生。应该在 加强对肥胖孕产妇的围生期监护及产后随访的同时，积极控制孕期体质量的增加。

Abstract:

Objective To explore the relationship of progestation body mass index (BMI) and gestational weight gain and pregnancy outcomes among rural pregnant women.Methods The related variables of 658 eligible participants were calculated and sorted, which included BMI, complications, delivery mode and birth process by retrospective study.Results Progestation BMI≥25.0 kg/m2 was significantly associated with an increased risk of gestational diabetes mellitus (GDM) （RR=3.80, 95%CI 2.36-6.12）, hypertension（ RR=3.50, 95% CI 2.15- 5.72）, puerperal infection（RR=7.48, 95% CI 2.49- 22.44）, abnormal birth process（RR=4.79, 95%CI 3.77-6.09）, cesarean delivery（RR=1.81, 95%CI 1.65-1.97） and macrosomia（ RR=5.14, 95%CI 2.90-9.10）. Meanwhile, pregnant women who were gestational weight gain 15 kg were more likely to get GDM（RR=3.56, 95%CI 1.96-6.47）, hypertension（RR=1.79, 95%CI 1.06- 3.01）, puerperal infection（RR=4.41, 95% CI 1.31- 14.88）, abnormal birth process （RR=2.52, 95% CI 1.93- 3.30）and macrosomia（RR=2.80, 95% CI 1.52- 5.17）. Conclusions Progestation BMI≥25.0 kg/m2and gestational weight gain 15 kg can increase the incidence of pregnancy complications and adverse pregnancy outcomes. We should strengthen prenatal care and postpartum follow- up whilst preventing gestational weight to overly again.

参考文献/References:

[1] Organization WHO. Obesity: preventing and managing a global epidemic ［J］． World Health Organ Tch Rep Ser, 2000,894: 1-4.
[2］ Lashen H, Fear K, Sturdee DW. Obesity is associated with in? creased risk of first trimester and recurrent miscarriage: matched case- control study ［J］． Hum Reproduct, 2004,19 (7): 1644-1646.
[3］ 乐杰.妇产科学［M］． 6 版.北京:人民卫生出版社,2004:97- 159.[1] Organization WHO. Obesity: preventing and managing a global epidemic ［J］． World Health Organ Tch Rep Ser, 2000,894: 1-4.
[2］ Lashen H, Fear K, Sturdee DW. Obesity is associated with in? creased risk of first trimester and recurrent miscarriage: matched case- control study ［J］． Hum Reproduct, 2004,19 (7): 1644-1646.
[3］ 乐杰.妇产科学［M］． 6 版.北京:人民卫生出版社,2004:97- 159.[1] Organization WHO. Obesity: preventing and managing a global epidemic ［J］． World Health Organ Tch Rep Ser, 2000,894: 1-4.
[2］ Lashen H, Fear K, Sturdee DW. Obesity is associated with in? creased risk of first trimester and recurrent miscarriage: matched case- control study ［J］． Hum Reproduct, 2004,19 (7): 1644-1646.
[3］ 乐杰.妇产科学［M］． 6 版.北京:人民卫生出版社,2004:97- 159.[1] Organization WHO. Obesity: preventing and managing a global epidemic ［J］． World Health Organ Tch Rep Ser, 2000,894: 1-4.
[2］ Lashen H, Fear K, Sturdee DW. Obesity is associated with in? creased risk of first trimester and recurrent miscarriage: matched case- control study ［J］． Hum Reproduct, 2004,19 (7): 1644-1646.
[3］ 乐杰.妇产科学［M］． 6 版.北京:人民卫生出版社,2004:97- 159.
[4］ 童锦,顾宁,李洁,等.孕前体重指数和孕期增重对妊娠结局的影 响［J］．中华围产医学杂志,2013,16(9):561-565.
[5］ 冒志琴,汪之硕.孕期体质量指数孕期增重与妊娠结局的相关性 分析［J］．山西医药杂志,2013,42(9):996-998.
[6］ Lu GC, Rouse DJ, DuBard M, et al. The effect of the increas? ing prevalence of maternal morbidity ［J］．Am J Obstet Gyne? col, 2001,185(4):845-849.
[7］ 张洪芹,吕耀凤,蔺香云,等.孕前肥胖及孕期体重增长过度与妊 娠期并发症及分娩结局的关系探讨［J］．实用妇产科杂志, 2007,23(2):117-119.
[8］ 谢敏,刘阳.孕期肥胖与妊娠并发症及分娩结局的关系［J］．中 国实用医刊,2009,36(17):25-26.
[9］ Schneid KN, Sheiner E, Levy A, et al. Risk factors for wound infection on following cesarean deliveries ［J］． Int J Gynaecol Obstet, 2005,90(1):10-15.
[10］ Devader SR, Neeley HL, Myles TD, et al. Evaluation of ges? tational weight gain guidelines for women with normal pregnan? cy body mass index ［J］． Obstet Gynecol, 2007,110(4):745- 751.
[11］ Shirazian T, Monteith S, Friedman F, et al. Lifestyle modifi? cation program decreases pregnancy weight gain in obese wom ? en ［J］．Am J Perinatol, 2010,27(5):411-414.

备注/Memo

备注/Memo:

作者简介：李春荣，博士在读，研究方向为妇女保健及健康行为促进 通信作者：李春荣，E-mail: cdlcr@163.com

常用功能

更新日期/Last Update: 2014-08-30