孕妇体质量及其他因素与分娩巨大儿的相关性研究

发布时间：2019-04-18 07:47

【摘要】：目的:探讨孕妇孕前和孕期体质量及有关因素与分娩巨大儿的相关性,为其预防提供指导。方法:选择2013年1月1日至2014年12月31日在四川大学华西第二医院住院分娩符合纳入标准的孕产妇10044例,其中分娩巨大儿466例,非巨大儿9578例。采用Logistics回归分析孕妇体质量及其他因素(妊娠期糖尿病、分娩巨大儿史、多胎妊娠等)与分娩巨大儿的相关性及不同BMI分类与分娩巨大儿的相关性。结果:(1)孕前BMI、孕期总体质量增长、妊娠期糖尿病及既往分娩过巨大儿是分娩巨大儿的独立危险因素(P0.05);多胎妊娠是分娩巨大儿的保护因素(P0.05)。(2)通过BMI分层后,对于孕前BMI正常者,孕期体质量增长过少和多胎妊娠是分娩巨大儿的保护因素(P0.05);孕期总体质量增长、孕期体质量增长过多、有巨大儿分娩史是分娩巨大儿的独立危险因素(P0.05)。对于孕前体质量过轻者,孕期总体质量增长和孕期体质量增长过多是分娩巨大儿独立危险因素(P0.05)。对于孕前超重的孕妇,孕期总体质量增长和妊娠期糖尿病是分娩巨大儿独立危险因素(P0.05)。结论:孕前BMI过高、孕期体质量增长过多、发生妊娠期糖尿病及既往分娩巨大儿史均可使再次妊娠发生巨大儿的风险明显增高;孕前不同BMI孕妇其分娩巨大儿的危险因素有不同,孕期体质量增长过多可能增加孕前偏瘦和体质量正常孕妇巨大儿的发生风险。
[Abstract]:Objective: to investigate the correlation between pregnant women's body mass before and during pregnancy and the birth macrosomia in order to provide guidance for its prevention. Methods: from January 1, 2013 to December 31, 2014, 10044 pregnant women (466 macrosomia and 9578 non-macrosomia) who were hospitalized in West China second Hospital of Sichuan University were selected. Logistics regression was used to analyze the correlation between gestational diabetes mellitus (GDM) and other factors (gestational diabetes mellitus (GDM), history of birth macrosomia, multiple pregnancy, etc.) and the relationship between different BMI classification and fetal macrosomia. Results: (1) the overall quality of BMI, was increased before pregnancy. Gestational diabetes mellitus (GDM) and previous macrosomia were independent risk factors for macrosomia (P0.05). Multiple pregnancy is the protective factor of macrosomia (P0.05). (2) after BMI stratification, for those with normal BMI before pregnancy, too little weight gain during pregnancy and multiple pregnancy are protective factors of macrosomia (P0.05); The birth history of macrosomia was an independent risk factor for macrosomia (P0.05). The overall weight increase during pregnancy and body mass increase during pregnancy were independent risk factors for macrosomia (P0.05). For pregnant women who were overweight before pregnancy, the overall quality increase during pregnancy and gestational diabetes mellitus were independent risk factors for macrosomia (P0.05). Conclusion: BMI is too high before pregnancy and body mass increases too much during pregnancy. Gestational diabetes mellitus (GDM) and the history of previous birth can significantly increase the risk of macrosomia in the second pregnancy. The risk factors of birth macrosomia were different in different pregnant women with BMI before pregnancy. Too much body mass increase during pregnancy may increase the risk of pregestation lean and normal weight pregnant women with macrosomia.
【作者单位】：四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室;
【基金】：四川省科技厅科技支撑项目(编号:2013SZ0004)
【分类号】：R714

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