孕前体质量指数与妊娠不良结局的相关性研究

目的探讨孕前体质量指数(BMI)与妊娠不良结局相关性。方法收集4 614例分娩的孕妇临床资料,根据孕前BMI不同将其分为低体质量组、正常体质量组、超重组和肥胖组,比较各组的子痫前期、妊娠期糖尿病、剖宫产、新生儿死亡、妊娠高血压、巨大胎儿、胎膜早破、耐糖量异常、产后出血等妊娠不良结局的发病率。结果低体质量组占13.5%,正常体质量组占70.5%,超重组占13.4%和肥胖组占2.6%。随着孕前BMI的增大,妊娠期的不良结局的风险也越来越大。除新生儿死亡以外,在其他妊娠不良结局中超重组和肥胖组的发病率要明显要高于正常体质量组,差异具有统计学意义(P0.05)。低体质量组的产后出血、耐糖量异常、新生儿死亡、剖宫产、妊娠期糖尿病的发病率与正常体质量组相比无明显的差异(P0.05),而子痫前期、妊娠高血压、巨大胎儿、胎膜早破的发生率明显低于正常体质量组,差异具有统计学意义(P0.05)。结论孕妇的孕前BMI对妊娠不良结局有较大的影响,加强对孕妇的孕前BMI控制,可以减少母婴并发症。

Study on effect of pre-pregnancy body mass index on adverse outcome of pregnancy

Objective To explore the significance of pre-pregnancy body mass index（ BMI） in adverse outcome of pregnancy. Methods A total of 4 614 nulliparous. women selected on population-based cohort were categorized into 4 groups,pre-eclampsia,emergency caesarean,gestational diabetes,postpartum haemorrhage,and other adverse pregnancy outcomes were compared among them by univariate and multivariate analyses. Results They were classified by pre-pregnancy BMI,625 women as underweight（ 13. 5%）,3 253 as normal（ 70. 5%）,617 as overweight（ 13. 4%）,and 119 as obese（ 2. 6%）. The risk of adverse pregnancy outcome had been increased with the increase of pre-pregnancy BMI（ P〈0. 05）. The risks for gestational hypertension,pre-eclampsia,gestational diabetes,and preterm premature rupture of membranes were higher for those with overweight or obese before pregnancy（ P〈0. 05）. There was no significant difference existed between underweight and normal body weight in the occurrence of postpartum hemorrhage,gestational impaired glucose tolerance,cesarean delivery,gestational diabetes mellitus and mortality of infants. There was significant difference between underweight and normal weight in pre-eclampsia,preterm premature rupture of membranes,hypertension and macrosomia. Conclusion High pre-pregnancy body mass index is associated with increased risk of adverse outcome of pregnancy,hence pre-pregnancy body mass index should be properly managed.