孕期体重增加的影响因素与新生儿出生体重的队列研究

发布时间：2018-01-22 01:11

本文关键词： 孕期增重新生儿体重基本情况锻炼习惯被动吸烟孕前BMI　出处：《河北医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:描述河北省孕妇的一般情况和生活方式的现状,分析影响孕期体重增加和新生儿出生体重的关键因素,进一步探讨孕期体重增加与新生儿出生体重的关联。方法:选取2013年3月—2014年5月,经知情同意,纳入孕6-12周内在所指定社区卫生服务中心或医院产科门诊建本并拟定期来检查和分娩的早孕妇女共586例,对调查者进行孕妇生活方式与母婴健康调查项目,建立健康档案并对各项健康指标进行追踪观察。调查指标包括孕前身高和体重,孕6-12周、孕28周、孕36周及分娩前、后的体重及产后附属物的重量,孕妇24小时膳食回顾调查和体力活动调查,以及妊娠结局、新生儿出生体重、出生身长、出生头围等。建立EPIDATA数据库,双人录入,采用SPSS13.0和SAS9.3软件进行统计分析。计量资料以“均数±标准差”表示,计数资料以构成比表示,两样本均数比较采用t检验,多组计量资料比较采用单因素方差分析,计数资料的分析采用卡方检验,与不同孕期体重增加的影响因素采用多分类有序logistic回归分析,和新生儿出生体重相关的影响因素采用多元线性回归分析,显著性检验水准均取双侧α=0.05。结果:石家庄9所社区卫生服务中心及衡水2所医院共计586例孕妇纳入此次调查,并分娩单胎活产儿。排除失访(n=33)、流产(n=21)、引产(n=4)、胎停育(n=3)后,共计525名分娩单胎活产儿的孕妇进入数据统计分析。剖宫产(n=229)、自然分娩(n=296),经产妇(n=76)、初产妇(n=449)。孕前平均体质指数(21.21士3.02)kg/m2,孕期体重平均增加(15.80士3.55)kg,高于推荐的12.5kg,新生儿平均出生体重(3400.5±427.92)g,大多集中在正常范围内。孕期体重增加分为三组:孕期体重增加不足组(n=46),占8.76%;孕期体重增加正常组(n=239),占45.52%;孕期体重增加过度组(n=240),占45.71%。不同孕期体重增加情况与孕妇年龄、孕前BMI、孕期是否锻炼、孕中、晚期是否被动吸烟、新生儿体重具有相关性(P0.05)。孕期体重增加不足组和过度组的BMI均大于正常组;31-35岁平均孕前体质指数最高(22.0±2.9)kg/m2;妊娠期体重增加随着年龄增加而降低;孕妇在孕期不锻炼者比锻炼者孕期体重增加较高;孕妇在孕中、晚期被动吸烟者孕期体重增加较高;母亲孕期体重增长越多,新生儿出生体重越大。孕期体重增加情况与胎盘重量、生产次数等不存在显著相关,差异无统计学意义(P0.05)。新生儿出生体重与孕早期是否锻炼、丈夫孕前一个月是否吸烟、孕中、晚期是否被动吸烟、孕妇家是否有高血压、胎盘重量之间具有相关性(P0.05)。孕早期无锻炼者,新生儿出生体重高于孕早期有锻炼的孕妇;丈夫孕前一个月吸烟的,孕中、晚期被动吸烟者,新生儿体重较高;胎盘重量大的孕妇分娩的新生儿体重高于胎盘重量低的孕妇;孕妇家有高血压的,新生儿体重较低。新生儿出生体重与孕妇年龄、孕前体质指数BMI等不存在显著相关,差异无统计学意义(P0.05)。不同孕期体重增加情况的多因素有序logistic回归分析显示,孕妇年龄、孕前体质指数BMI、孕中期是否经常锻炼和新生儿体重是孕期体重增加的独立影响因素,孕妇年龄和孕期体重增加存在显著的负相关。新生儿出生体重的多元线性回归分析显示,胎盘重量、孕晚期被动吸烟、孕早期没有锻炼习惯和孕妇家有高血压是新生儿体重的独立危险因素。孕早、中、晚三期能量和产能营养素(蛋白质、脂肪和碳水化合物)的摄入情况较为理想,随孕周增加,能量和产能营养素摄入均在增加,且能量摄入数据在合理范围内。结论:孕妇年龄、孕前BMI、孕期是否锻炼、孕期是否被动吸烟、新生儿出生体重是不同孕期体重增加的影响因素。孕期是否锻炼、孕期是否被动吸烟、丈夫是否在孕前吸烟、胎盘重量是新生儿出生体重的影响因素。孕期营养摄入较为合理。
[Abstract]:Objective: to describe the status of pregnant women in Hebei province of the general situation and the way of life, analysis the influence factors of weight gain during pregnancy and neonatal birth weight, gestational weight gain and to further explore the association of neonatal birth weight. Methods: from March 2013 to May 2014, after informed consent, included in the 6-12 weeks of gestation within designated community health service center or hospital the construction of gynecology clinic and intends to check regularly and delivered a total of 586 cases of pregnant women, pregnant women and maternal and child health lifestyle survey project of the survey, the establishment of health records and follow-up observation of the health indicators. Survey indicators including prepregnancy weight and height, gestational age of 6-12 weeks, at 28 weeks, 36 weeks of pregnancy and childbirth before, after the weight and the weight of pregnant women postpartum appendages, 24 hour dietary survey and physical activity survey, and the outcome of pregnancy, birth weight, birth Length, head circumference and so on. The establishment of EPIDATA database, double entry, statistical analysis was performed using SPSS13.0 and SAS9.3 software. Measurement data were expressed as the "standard deviation", count data to the constituent ratio, two samples were compared using t test, multiple sets of measurement data were compared with single factor analysis of variance, analysis. The data were analyzed by chi square test, and the influencing factors of different pregnancy weight regression analysis using polytomous logistic, and neonatal birth weight related factors using multiple linear regression analysis, significant test level was taken from bilateral alpha =0.05. results: the survey a total of 586 cases of pregnant women in the 2 Shijiazhuang 9 community health service center and the Hengshui hospital, and delivered single live births. Excluding missing (n=33), (n=21), induced abortion (n=4), stop child education (n=3), a total of 525 pregnant women who delivered singleton live births into data Statistical analysis of cesarean section (n=229), natural childbirth (n=296), (n=76), multipara primipara pregnancy (n=449). The average body mass index (21.21 + 3.02) kg/m2, pregnancy weight increased by an average of (15.80 + 3.55) kg, higher than that recommended by 12.5kg, the average birth weight (3400.5 + 427.92) g, mostly concentrated in the normal range. The weight increase during pregnancy were divided into three groups: gestational weight gain (n=46), insufficient group accounted for 8.76%; pregnancy weight gain in normal group (n=239), accounting for 45.52%; excessive weight gain during pregnancy group (n=240), accounting for 45.71%. of different weight gain during pregnancy and maternal age, pre pregnancy BMI pregnancy exercise, pregnancy, whether passive smoking is associated with neonatal birth weight, gestational weight gain (P0.05). Lack of group and over group BMI were higher than that in normal group; 31-35 years average pregnancy body mass index highest (22 + 2.9) kg/m2; gestational weight gain decreased with age; pregnant women Do not exercise during pregnancy increased higher than exercise weight during pregnancy; pregnant women during pregnancy and late pregnancy weight gain higher passive smokers; maternal weight gain more and more. The birth weight of newborns weight gain during pregnancy and placental weight, production times are not significantly related to the difference was not statistically significant (P0.05). Birth body weight and early pregnancy is a month before exercise, husband smoking, pregnancy, late pregnant women whether passive smoking, not associated with hypertension, placental weight between early pregnancy (P0.05). No exercise, weight is higher than the early pregnancy exercise pregnant women birth; her husband before one month smoking, pregnancy in the late stage, passive smoking, high birth weight childbirth; birth weight placental weight is higher than that of large placental weight low pregnant women; pregnant women with hypertension, neonatal weight Low neonatal birth weight and maternal age, pre pregnancy body mass index was not significantly related to BMI, the difference was not statistically significant (P0.05). Multivariate ordinal logistic different maternal weight gain of the regression analysis showed that maternal age, pre pregnancy body mass index BMI, the second trimester whether regular exercise and weight of newborns were independent factors of pregnancy weight the increase of maternal age and gestational weight gain was significantly negative correlation. Multiple linear regression analysis showed that the neonatal birth weight, placental weight, late pregnancy in early pregnancy without passive smoking, exercise habits and pregnant women with hypertension were independent risk factors of neonatal weight. In early pregnancy, late in the three period, energy and capacity of nutrition peptide (protein, fat and carbohydrate intake) is ideal, with the increase of gestational age, energy and nutrient intake capacity increased, and energy intake data In a reasonable range. Conclusion: maternal age, pre pregnancy BMI, pregnancy exercise during pregnancy, whether passive smoking, neonatal birth weight is different influencing factors of pregnancy weight gain during pregnancy. Whether exercise, whether passive smoking during pregnancy, whether the husband before smoking, placental weight infant birth weight is affected by maternal nutrition intake is more. Reasonable.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R715.3

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