孕早期孕妇体成分与分娩巨大儿的相关性

 目的 探讨孕早期孕妇体成分与分娩巨大儿的相关性。方法 回顾性纳入2016年1—9月在重庆市永川区妇幼保健院分娩的孕妇1697例,调查巨大儿分娩相关危险因素及孕早期体成分,随访其分娩结局。运用logistic回归分析对包括孕早期体成分各指标在内的各项可能危险因素与分娩巨大儿的相关性。结果 最终纳入1522例为研究对象。孕早期BMI≥28 kg/m²分娩巨大儿的风险是同期正常BMI(18.5~23.9)的3.75倍,脂肪重量>实际体重×0.28的孕妇分娩巨大儿的风险是脂肪重量＜实际体重×0.2的孕妇的4.21倍,体脂率≥30%的孕妇分娩巨大儿的风险是体脂率＜30%的孕妇的1.86倍,去脂体重＞实际体重×0.8使分娩巨大儿的风险降低了76%。孕早期BMI、体脂重量和体脂率为分娩巨大儿的独立危险因素,去脂体重为保护因素。结论 孕早期BMI及体成分与分娩巨大儿密切相关,建议对孕早期肥胖及体脂肪超标的孕妇进行营养和运动干预,以降低巨大儿分娩风险。

Correlations between body composition of early pregnant women and macrosomia risk

Objective To explore the association between body composition of early pregnant women and macrosomia risk.Methods We retrospectively included 1697 pregnant women who had given birth in Yongchuan Maternity and Child Health Hospital of Chongqing between January and September in 2016. Macrosomia related risk factors as well as body composition of early pregnant women were investigated and follow-up was performed until the cessation of pregnancy. Logistic regression analysis was used to explore the association between macrosomia and potential risk factors, including body composition of early pregnant women.Results BMI of early pregnancy, body fat weight and body fat percentage were independent risk factors for macrosomia. Fat-free mass was an independent protective factor. Early pregnant women with BMI≥28 were 3.75 times as likely to have macrosomic newborns as those with normal BMI (18.5-23.9). Similarly, pregnant women with fat weight greater than 0.28 times body weight were 4.21 times as vulnerable as those with fat weight less than 0.2 times body weight. Pregnant women with a body fat percentage≥30% were 1.86 times as vulnerable as those with a body fat percentage＜30%. Pregnant women with fat-free mass greater than 0.8 times body weight had a 76% decreased risk for macrosomic newborns.Conclusions BMI and body composition of early pregnancy are associated with macrosomia risk. Nutrition and exercise interventions are recommended in those early pregnant women with obesity and excessive body fat to reduce the risk of macrosomia.