巨大儿影响因素及干预效果分析

目的探讨巨大儿影响因素，提出社区综合性干预的有效方法。方法以2007年建立孕妇联系册的早孕妇女作为干预组对象，对干预组进行营养、运动指导和健康教育，观察巨大儿发生率等妊娠结局，并对干预方法进行评估，同时以2003-2006年出生资料为对照组。结果对照组巨大儿发生率为7．28％，干预组巨大儿发生率4．69％，但经卡方检验（Х^2=2．041，P〉0．05）无显著性差异；巨大儿组孕妇孕前和分娩前体重高于非巨大儿组，经t检验差别有显著性差异意义（P〈0．05）；干预后孕妇三餐供能比达标率高于干预前，且孕妇的认知水平明显提高；所有访谈对象一致认为需要接受孕期保健的专业指导。结论巨大儿的发生与多种因素相关，尤其是营养状况与胎儿生长发育关系密切，应采取综合干预措施，开展多层次、多形式的健康教育。

Analysis on the influencing factors of fetal macrosomia and its preventive measure

Objective To analyze the influencing factors of fetal macrosomia and propose some community preventive measure. Method Pregnant women with contact handbook were selected as study group. Directions on nutrition and exercise as well as health education were carried to the study group, the birth rate of fetal macrosomia was observed. The birth data in the year of 2003 to 2008 were considered as control group. Results The birth rate of fetal macrosomia of the control group and the study group were 7. 28% and 4.69% respectively. The fetal macrosomia mothers were weightier than the other pregnant women before pregnancy and before delivery. The three meal energy ratio and the knowledge about preventing fetal macrosomia of the study group were improved after the preventive measure. Professional directions on pregnant health were needed to all interviewee of the study group. Conclusion Many factors are interrelated with fetal macrosomia. There are close relation between the nutrition of pregnant woman and the growth of fetus. Pregnant woman need health knowledge very much. Multilayer and multiform health education should be applied to the pregnant woman.