孕前 BMI、孕期体重增加与新生儿出生体重关系探讨

目的：探讨孕前不同体重指数（BMI）妇女孕期体重增加与新生儿出生体重的关系。方法回顾性分析2013年7—12月在北京市海淀区妇幼保健院建档、产前检查并分娩的单胎足月孕产妇资料，包括年龄、身高和孕前体重，分娩前体重，分娩孕周及新生儿出生体重等指标。结果4927例孕妇孕期平均体重增加（16.5±4.3）kg，胎儿出生体重平均为（3402.3±381.8）g，剖宫产率为34.7％。孕妇体重增加过多组、适中组和不足组的比例分别为32.9％、53.3％和13.8％，孕前不同 BMI 各组体重增长差异有统计学意义，随着孕前 BMI 增加，孕期增重数值呈下降趋势，组间差异有统计学意义。孕期体重增加与胎儿出生体重呈正相关（r ＝0.26）。分娩适宜胎龄儿3933例，孕前低体重组、孕前正常体重组、孕前超重组和肥胖组孕期增重适宜范围分别为14.0～19.0 kg、14.0～19.0 kg、11.5～17.0 kg 和8.0～16.5 kg，超过美国 IOM推荐范围，孕期体重增加的中位数（P50）分别为17.0 kg、16.0 kg、14.0和12.0 kg，孕期体重平均增加15.0kg（P50）。结论孕前 BMI、孕期孕妇体重增加与新生儿出生体重相关，孕期体重增加超过 IOM推荐范围，做好孕期体重管理势在必行。

Gestational weight gain and its relationship with the birth weight of offspring by pre-pregnancy body mass index

Objective To evaluate gestational weight gain(GWG)and its relationship with the birth weight of offspring according to pre-pregnancy body mass index(BMI). Methods A retrospective study sample enrolled 4 927 singleton pregnancy women with complete records,who had full record of pre-pregnancy weight and GWG as to delivered at hospital between July and December 2013.Conditions of mothers and babies were recorded,including maternal age, height,prepregnant weight,pregnant weight,gestational weeks on delivery,delivery mode and newborn birth weight. Results Mean gestation weight gain were (16.5 ±4.3)kg,the average birth weight of the babies was 3402.3 ±381.8 g. Cesarean delivery rate was 34.7%.Women were grouped by pre-pregnancy body mass index (BMI)and were then classified as having less than,within,or greater than recommended rates of gain.The rate of each group were 32.9%, 53.3% and 13.8%,respectively.There are3933 appropriate birthweight babies in the three groups.For their mothers in the underweight,normal weight,overweight and obese group,the recommended range of GWG were 14.0-19.0 kg,14.0-19.0 kg,11.5-17.0 kg and 8.0-16.5 kg,respectively.The average GWG for all women was 15.0 kg. Conclusion BMI before pregnancy and weight gain in pregnancy are associated with birth weight of offspring,Excess weight gain was prevalent as compare as IOMguidelines.Interventional trials of targeted weight gain during pregnancy are urgently needed.