孕前体重及孕期体重增长与巨大儿发生的关系

发布时间：2018-04-24 10:29

本文选题：孕前体重 + 孕期体重增长　；参考：《中国循证儿科杂志》2015年06期

【摘要】：目的研究孕前体重状况与孕期体重增长与巨大儿发生的关系。方法以上海2家医院健康产妇为研究对象。采集产妇指标(年龄、身高、孕前BMI、文化程度、既往疾病史、分娩前体重、血三酰甘油)和新生儿指标(性别、出生体重、出生身长、出生孕周)。采用二项Logistic回归进行多因素分析。以孕前BMI分组,将新生儿是否为巨大儿作为因变量,孕期增重作为检验变量,对孕前营养不良、正常和超重(肥胖)组分别使用ROC曲线计算界值,得出孕期合理体重增长的上限值。结果共纳入1 286例产妇,平均年龄(28.8±3.7)岁。孕前营养不良、正常和超重(肥胖)组分别为239例(18.6%)、872例(67.8%)和175例(13.6%)。孕期平均增重(15.4±4.7)kg,其中孕期体重增长过少206例(16.0%)、正常4 8 8例(3 7.9%)、过多5 9 2例(4 6.0%)。新生儿出生体重(3 3 8 0±3 8 4)g,巨大儿发生率6.0%(77/1 286)。孕前营养不良、正常和超重(肥胖)组巨大儿发生率分别为2.9%(7/239)、5.6%(49/872)和12.0%(2 1/1 7 5)。巨大儿产妇孕周、孕前BMI、孕期增重、高三酰甘油血症发生率均明显高于正常出生体重儿产妇。多因素Logistic分析显示孕前超重、孕周增加、孕期体重增长过多和高三酰甘油血症是巨大儿发生的危险因素。孕前营养不良、正常和超重(肥胖)组孕期体重增重界值分别为20.8、14.8和15.3 kg。结论孕前超重、孕周增加、孕期体重增长过多和高三酰甘油血症与巨大儿发生相关。
[Abstract]:Objective to study the relationship between pre-pregnancy weight and weight gain during pregnancy and macrosomia. Methods healthy puerpera in 2 hospitals in Shanghai were studied. Maternal indicators (age, height, pre-pregnancy BMIs, education, history of illness, weight before delivery, triglyceride) and neonatal indicators (sex, birth weight, body length, gestational age) were collected. Multivariate analysis was performed by binomial Logistic regression. According to pre-pregnancy BMI group, whether the newborn is macrosomia as dependent variable, pregnancy weight gain as test variable, the ROC curve was used to calculate the boundary value of pre-pregnancy malnutrition, normal and overweight (obesity) group. The upper limit of reasonable weight gain during pregnancy is obtained. Results A total of 1 286 cases of parturient were included, with an average age of 28.8 卤3.7 years. In the group of malnourished before pregnancy, 239 cases of normal and overweight (obesity) group were 872 cases with 872 cases of malnourishment and 175 cases with 13.6 cases. The average weight gain during pregnancy was 15.4 卤4.7 kg, among which 206 cases with low weight gain during pregnancy were 16.0%, 48 normal cases with 37.9% weight gain and 59.2 cases with excessive weight gain 46.0%. The birth weight of the newborn was 338.0 卤38.4 g, and the incidence of macrosomia was 6.0% or 1.286%. The incidence of macrosomia in prepregnancy malnutrition, normal and overweight (obesity) groups were 2.9 / 239and 5.66 / 872) and 12.0 / 17.5 respectively. The incidence of gestational week, BMI, weight gain and hypertriglyceridemia in macrosomia were significantly higher than those in normal birth weight infants. Multivariate Logistic analysis showed that overweight before pregnancy, increased gestational weeks, excessive weight gain during pregnancy and hypertriglyceridemia were risk factors for macrosomia. The weight gain limits of prepregnancy malnutrition, normal and overweight (obesity) groups were 20.8- 14.8 and 15.3 kg, respectively. Conclusion overweight before pregnancy, increased gestational weeks, excessive weight gain during pregnancy and hypertriglyceridemia are associated with macrosomia.
【作者单位】：上海交通大学医学院附属仁济医院临床营养科;上海市长宁区妇幼保健院营养科;
【分类号】：R714.7

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