孕前体质量指数及孕期增重对产妇及新生儿的影响

目的:分析孕前体质量指数及孕期增重对产妇及新生儿的影响.方法:以900例具有完整产科资料的妊娠女性作为受试对象,依据孕前的体质量指数(BMI)的不同将孕妇分为消瘦组(BMI<20 kg/m2)、正常组(20 kg/m2≤BMI<25 kg/m2)和肥胖组(BMI≥25 kg/m2);依据孕期体质量增加的不同,将孕妇分为:<15 kg组、15~20 kg组和>20 kg组.观察孕前不同BMI和体质量增加的不同程度对产妇最终分娩方式和分娩结局的影响.结果:消瘦组、正常组和肥胖组3组孕妇顺产率依次降低,剖宫产率依次升高(P<0.01).随着孕期体质量增加量的升高,剖宫产率、巨大儿出生率均呈升高趋势(P<0.01).消瘦组、正常组和肥胖组在妊娠期高血压、妊娠期糖尿病、产程阻滞、产后出血以及新生儿窒息检出率依次升高(P<0.01);肥胖组孕妇随着孕期体质量增加量的逐渐升高,妊娠期高血压、妊娠期糖尿病和产后出血检出率逐渐升高(P<0.01).结论:孕前肥胖和孕期增重过多可提高妊娠期高血压、妊娠期糖尿病等合并症的发病风险,亦可显著增加剖宫产率、巨大胎儿率、不良妊娠结局如产程阻滞、产后出血以及新生儿窒息等发生风险.

Effect of maternal body mass index on pregnant woman and newborn

Objective:To analyze the effects of maternal body mass index(BMI) on pregnant women and newborn.Methods:Nine hundred pregnant women were divided into the lean group(BMI<20 kg/m2),normal group(20 kg/m2≤BMI<25 kg/m2) and obesity group(BMI≥25 kg/m2) according to the BMI before pregnancy.The pregnant women were divided into the less than 15 kg group,15 to 20 kg group and more than 20 kg group according to the body mass increasing degree during pregnancy.The effects of maternal BMI before pregnancy and body mass increasing on the delivery mode and outcome of pregnant women were recorded. Results:The spontaneous labor rate and cesarean section rate in lean group,normal group and obesity group decreased and increased successively, respectively(P<0.01).With the increasing of body weight of pregnant women,the cesarean section rate and macrosomia birth rate showed an upward trend(P <0. 01). The detection rates of gestational hypertension,gestational diabetes,labor block,postpartum hemorrhage and neonatal asphyxia in lean group,normal group and obesity group increased gradually(P<0.01).With the increasing of body mass during pregnancy,the detection rates of gestational hypertension,gestational diabetes,postpartum hemorrhage in obesity group increased gradually(P <0. 01). Conclusions:Obesity and excessive increasing weight during pregnancy can improve the risk of gestational hypertension and diabetes,which also can significantly increase the cesarean section rate,fetal macrosomia occurrence,and adverse pregnancy outcomes(such as labor block,postpartum hemorrhage and neonatal asphyxia).