双胎妊娠孕期不同阶段体质量增长速度与母婴结局的关系

发布时间：2018-04-06 20:40

本文选题：双胎妊娠　切入点：体质量　出处：《实用妇产科杂志》2017年05期

【摘要】：目的:分析双胎妊娠孕期不同阶段体质量增长情况与母婴结局的关系。方法:对2013年1月至2015年10月在上海交通大学医学院附属国际和平妇幼保健院住院分娩的472例双胎妊娠产妇的临床资料进行回顾性分析,比较不同孕前BMI孕妇孕期体质量增长情况,在校正年龄和孕前BMI后,使用二元Logistic回归分析孕期不同阶段体质量增长速度与孕期并发症、早产、胎膜早破和新生儿出生体质量的关系。结果:(1)孕早中期平均体质量增长速度0.41±0.15 kg/w,孕晚期平均体质量增长速度0.64±0.30 kg/w,整个孕期平均体质量增长速度0.49±0.15 kg/w。(2)孕晚期和整个孕期体质量增长过快是妊娠期高血压疾病和发生早产的高危因素(P0.05),孕早中期、孕晚期及整个孕期体质量增长过快是发生胎膜早破的高危因素(P0.05),孕早中期及整个孕期的体质量增长过慢是新生儿低出生体质量的高危因素(P0.05)。(3)在校正年龄、孕前BMI、孕周等因素后,孕期体质量每增加1 kg,双胎出生体质量之和增加25.21 g(P0.001);孕早中期每增加1 kg,双胎出生体质量之和增加30.89 g(P0.001);孕晚期每增加1 kg,双胎出生体质量之和增加21.46 g(P=0.001)。结论:双胎妊娠孕期体质量增长与母婴不良结局密切相关,妊娠不同阶段的体质量增长速度对母婴结局有一定的预测价值,应进一步探讨适合中国人群的双胎妊娠孕期体质量增长适宜范围。
[Abstract]:Objective: to analyze the relationship between the growth of body mass and the outcome of pregnancy in twin pregnancy.Methods: from January 2013 to October 2015, the clinical data of 472 pregnant women with twin pregnancy who were delivered in the International Peace Maternal and Child Health Hospital of Shanghai Jiaotong University from January 2013 to October 2015 were analyzed retrospectively.To compare the growth of body mass in pregnant women with BMI before pregnancy, after adjusting age and BMI before pregnancy, binary Logistic regression analysis was used to analyze the growth rate of body mass in different stages of pregnancy and complications during pregnancy, preterm delivery.Relationship between premature rupture of membranes and birth weight of newborns.Results the average body mass growth rate in the first trimester of pregnancy was 0.41 卤0.15 kg / w, in the third trimester was 0.64 卤0.30 kg / w, and in the whole pregnancy was 0.49 卤0.15 kg / w.m-2) the rapid growth of body mass in the third trimester and the whole pregnancy was the cause of hypertension complicating pregnancy.The high risk factors of disease and preterm delivery were P0.05, and the second trimester of pregnancy.The high risk factors of premature rupture of membranes were the rapid growth of body mass in the third trimester of pregnancy and the whole pregnancy. The slow growth of body mass in the second trimester and the whole pregnancy was the high risk factor of low birth weight of the newborn (P0.05. 3) after adjusting for age, BMIbefore pregnancy, gestational age, etc.The sum of body mass of twins increased by 25.21 g / P0.001 for each increase of 1 kg in pregnancy, 30.89 g / g P0.001 / kg for each increase of 1 kg in the first trimester of pregnancy, and 21.46 g / kg for the second trimester of pregnancy, and 21.46 g / kg for the second trimester of pregnancy.Conclusion: the growth of body mass in twin pregnancy is closely related to the adverse outcome of mother and child. The growth rate of body mass in different stages of pregnancy has certain value in predicting the outcome of mother and child.It is necessary to further explore the suitable range of body mass growth in twin pregnancy for Chinese population.
【作者单位】：上海交通大学医学院附属国际和平妇幼保健院;
【基金】：上海市教委护理高原学科项目(编号:Hlgy15007yjx)
【分类号】：R714.23

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