巨大儿发生的危险因素及产前预测

目的研究巨大儿发生的高危因素及产前预测，以便更好地指导孕妇孕期保健，减少新生儿及孕产妇的早期及远期并发症。方法对比巨大儿组及正常体重儿组两组孕妇的孕周、宫高、腹围，B超观察胎儿双顶径、胎儿腹围。回顾性分析孕妇孕前BMI、孕期体重增加情况、是否合并GDM等。结果①孕妇孕前BMI〉24、孕期体重增）加〉18kg、合并妊娠期糖尿病、孕周大于40周巨大儿组与正常体重儿组比较差异有统计学意义，为分娩巨大儿的高危因素。②胎儿腹同大于35cm，双顶径大于9．6cm，股骨长大于7．5cm，宫高＋腹围≥140cm，这4个指标巨大儿组与正常体重组比较差异有统计学意义，可作为巨大儿预测的方法。结论应该加强孕前及孕期指导，控制体重及血糖以降低巨大儿的发生率。对孕前胎儿体重采取多方面综合评估，以期能预测巨大儿的发生，以便做好相应的应对措施。

High risk factor and prenatal prediction on incidence of macrosomia

Objective To analyse the high risk factors of macrosomia, prenatal prediction. To guide pregnant women during pregnancy and also reduce early and long-term complications of maternity and neonatal. Methods 200 women were divided into two groups, macrosomia group and normal weight group. Prepregnancy BMI,weight gain during pregnancy, gestational diabetes, gestational weeks,fetal abdomen circumference, biparietal diameter, the femur length,fundal height plus abdominal circumference in the two groups were compared. Results ①There were statistically significant in prepregnancy BMI 〉24, weight gain during pregnancy 〉18kg, gestational diabetes mellitus and gestational age greater than 40 weeks of 2 groups.②Fe- tal abdomen circumference more than 35cm, biparietal diameter greater than 9.6cm, the femur length 〉7.5cm and fundal height plus abdominal circumference 〉140cm were good predictors of macrosomia. Conclusion Guidance for pregnancy should be strengthen. Body weight and blood glucose should be controlled in order to reduce the incidence of macrosomia. Fetal weight should be evaluated in many aspects in order to predict the occurrence of macrosomia well.