108例孕妇孕前BMI与孕期增重情况分析

目的 探讨孕妇孕前身体质量指数、孕期体重增重、脂肪分布与新生儿出生体重之间的关系,为进一步加强孕期营养指导工作提供建议.方法 问卷调查108名孕妇的基本情况,监测孕妇孕期体重增长情况,计算孕前身体质量指数、孕中期体重增幅及脂肪分布,并记录新生儿的出生体重.结果 72%的孕妇孕前营养状况正常,但孕中期73%的孕妇体重增加超过了适宜增重标准的60%,脂肪分布>140g/cm(肥胖)者占46%,孕中期脂肪分布与孕前身体质量指数呈正相关(rs=0.368,P<0.001).在已分娩的59名新生儿中,平均出生体重为3 272.7±398.6g,有6人的出生体重≥4 000g,新生儿出生体重与孕中期脂肪分布呈负相关(rs=-0.727,P<0.001).结论 孕妇在孕中期体重增长过多,巨大儿发生比例较高,因此加强孕期的营养指导,合理膳食对母亲及其新生儿出生体重具有重要意义.     

孕妇体质对母儿及分娩的影响

目的:探讨孕妇体质对母儿及分娩的影响。方法:对632例单胎、足月妊娠、无内外科合并症的孕妇自妊娠13周前开始至分娩定期测量体重、身高、计算体重指数(BMl),观察不同BMI组的妊娠并发症、分娩方式及新生儿情况。结果:孕前BMI≥28及分娩时BMI≥30者羊水过多发生率显著增加:分娩时BMI≥25以上特别是BMI≥30者及整个孕期体重增长≥20kg、整个孕期BMI增长在7以上者孕妇的剖宫产率、巨大儿发生率均显著增加。结论;孕前体重指数过重和孕期体重增长过多是妊娠并发症、不良妊娠结局的重要因素。根据本资料分析孕期体重增长应控制在20kg以内、孕期体重指数增加应控制在7以内。     

前次妊娠血糖异常妇女再次妊娠血糖情况及其与体重的关系

目的研究前次妊娠血糖异常妇女再次妊娠血糖情况,及再次妊娠血糖与孕前体重指数(BMI)和孕期体重增长的关系。方法选取2015年1月至2016年8月在北京市海淀区妇幼保健院分娩的经产妇160例,前次妊娠在本院有详细病例资料。前次妊娠诊断妊娠期糖尿病(GDM)或妊娠期糖耐量受损,本次妊娠诊断为GDM者56例,作为GDM组;前次妊娠诊断GDM或妊娠期糖耐量受损,本次妊娠血糖正常者96例,作为对照组。比较两组孕妇的年龄、本次及前次妊娠孕前BMI、本次及前次妊娠26周前体重增长情况、本次及前次妊娠孕期体重增长、两次妊娠间隔时间。结果前次妊娠血糖异常妇女本次妊娠诊断GDM者占35.0%,血糖正常者占60.0%,诊断糖尿病合并妊娠者占5.0%。对照组26周前体重增长本次妊娠少于前次妊娠,两次差异有统计学意义;而孕前BMI及孕期体重增长比较差异无统计学意义。GDM组本次妊娠与前次妊娠孕前BMI、孕26周体重增长、孕期体重增长比较,差异无统计学意义。本次妊娠26周前体重增长GMD组多于对照组,差异有统计学意义;而孕前BMI及孕期体重增长比较,两组差异无统计学意义。GDM组妊娠年龄、妊娠间隔时间与对照组比较,差异均无统计学意义。结论前次妊娠血糖异常妇女,再次妊娠应控制体重增长,以减少GDM的发生风险。     

妊娠期妇女血清叶酸水平的变化及其与婴儿出生体重的关系

本文对185名正常初产孕妇的血清叶酸水平、缺乏情况以及与婴儿出生体重的关系进行了研究。结果表明,血清叶酸水平随妊娠周数的增加呈下降趋势,孕中期、末期与早期相比,血清叶酸浓度明显降低,有显著差别。血清叶酸低于3ng/ml人数所占百分比由早期8.5％、中期9.7％至末期升至31.3％,三期共计31例,占总观察人数的16.8％。 对127名孕妇妊娠末期叶酸水平与婴儿出生体重的关系进行了分析,按婴儿出生体重分三组,母亲叶酸水平各组无显著差异。另对30名婴儿出生体重超过4000g的母亲,于产后24小时内取血测血清叶酸,结果与上述三种不同出生体重组母亲血清叶酸浓度亦无明显差别。本次研究未观察到孕期血清叶酸水平与婴儿出生体重之间有相关。     

孕晚期诊断子痫前期孕妇孕中期母体成分分析

目的比较孕晚期诊断的子痫前期(PE)孕妇孕中期母体成分与正常孕妇的差异,明确其孕中期是否已经出现体重及母体成分的异常变化。方法选取2012年10月-2013年9月在该院建卡并分娩,且孕28周以后诊断为PE的单胎孕妇42例为PE组,另选取同期在该院建卡、足月分娩的单胎健康孕妇42例为正常组,按照孕前身高、体重与PE组配对,回顾性分析孕中期(20~28周)体重及体重增长,同时比较使用生物电阻抗技术(BIA)测得的总体水、细胞内外液含量及蛋白质、矿物质、脂肪的差异,并比较两组孕28周及32周体重及体重增长有无差异。结果孕中期母体成分总体水、细胞内外液含量、蛋白质、矿物质、脂肪,两组比较差异无统计学意义(P0.05),孕中期体重及体重增长均PE组高于正常组,但差异无统计学意义(P0.05);孕28周体重PE组高于正常组,差异无统计学意义(P0.05);孕32周体重及体重增长均PE组明显高于正常组,差异均有统计学意义(P0.05,P0.01)。结论孕晚期诊断的PE孕妇在孕中期体重及体成分均未发生明显变化,但自孕晚期开始,PE组的体重增长开始异于正常组,且随着孕周进展体重增长的差异更加显著。     

母亲孕前体重指数和孕期增重对新生儿超重发生率的影响

目的探讨孕前体重指数(BMI)及孕期增重与新生儿出生体重的关系。方法通过查阅产科病例,采用系统抽样方法,收集2015年在北京某私立医院建立产检档案并分娩的单胎、足月、中国籍产妇的产科检查病例444名。以孕前BMI、孕期总增重、孕早期增重、孕中期增重、孕晚期增重为自变量,调整母亲的年龄、孕周、是否高危妊娠、吸烟、饮酒、是否有孕期糖尿病、新生儿性别等因素,分析自变量对出生体重的影响。结果孕前超重肥胖组新生儿巨大儿发病率(11.4%)是孕前正常体重组(5.8%)的2倍(RR=2.0);增重过多组巨大儿发病率(10.2%)是孕期增重适宜组(4.4%)的2.3倍(RR=2.3)。男孩巨大儿发生率(9.4%)明显高于女孩(1.3%)。采用多元线性回归分析显示,孕周、新生儿性别、孕前BMI、孕中期增重、母亲年龄均对出生体重有较明显的影响。建立回归方程为y=-2256.7+120.6×孕周-148.0×新生儿性别+9.3×妊娠糖尿病-46.8×高危妊娠+5.3×吸烟-70.1×饮酒+1.7×孕期总体重增长+28.6×孕前BMI+10.2×孕早期体重增长+18.4×孕中期体重增长+6.9×孕晚期体重增长+8.9×母亲年龄。结论孕前BMI和孕期体重增长是巨大儿发生的独立危险因素。     

妊娠期贫血与母体因素及妊娠结局关系的研究

本文对829名妇女妊娠期贫血状况进行了调查分析,测定不同孕期血红蛋白的含量,结果发现,妊娠合并贫血随孕周增加而增加,孕中期增加最为显著,至孕晚期总患病率为62.7％,妊娠期贫血能影响分娩时的孕周,是造成出生低体重儿的危险因子之一。     

5353例妊娠期妇女体重及体成分的测定与分析

目的探讨我国妇女孕期适宜的体重增长范围及体成分变化。方法选择在某院进行孕前及系统产前检查的健康育龄期妇女5 353名,按其孕周分4组,分别为孕前组,早孕组(孕12周),中孕组(孕13~26周)和晚孕期(孕27~孕39周)。采用生物电阻抗的方法,分别测定不同组别的育龄期妇女的体重、体重指数(BMI)、蛋白质含量、矿物质含量、脂肪含量、瘦体重、腰围、臀围等人体成分指标,比较不同组别的体重及体成分变化,绘制体重、BMI和体脂百分比增长曲线。结果不同孕期妇女的平均体重、体脂百分比、瘦体重、总水分分别为孕前:55.86 kg,29.33%,40.27 kg,28.48 L;早孕期:56.59 kg,29.49%,41.35 kg,28.87 L;中孕期:64.26 kg,32.49%,41.93 kg,31.56 L;晚孕期:66.91 kg,33.21%,43.65 kg,32.54 L。结论该研究获得了不同孕期妇女体重及体成分测定的参考值范围,为合理评价不同孕期妇女营养状况,控制孕期体重的适宜增加,减少孕期并发症及不良妊娠结局的发生提供了理论依据。     

妊娠期贫血与母体因素及妊娠结局关系的研究

本文对829名妇女妊娠期贫血状况进行了调查分析，珊定不同孕期血红蛋白的含量，结果发现，妊娠合并贫血随孕周增加而增加，孕中期增加最为显著，至孕晚期总患病率为62．7％，妊娠期贫血能影响分娩时的孕周，是造成出生低体重儿的危险因子之一。     

孕妇能量与巨大儿发生关系研究

目的了解哈尔滨市孕妇不同孕期能量摄入及体重增加与巨大儿发生的关系。方法采用队列研究方法,从孕早期开始监测整个孕期体重的动态变化,分别在孕早、中、晚三期进行连续3天24小时膳食回顾调查。收集妊娠结局及新生儿体格检查资料,分析巨大儿发生的危险因素。结果孕妇孕中期体重增加高,孕早期、中期能量及蛋白质的摄入量高于相应孕期营养素推荐摄入量(RNI),孕晚期低于相应孕期RNI(均P<0.05),但三大供能营养素各个孕期供能比例符合推荐比例。孕前体重指数(BMI)、分娩孕周、孕中期的能量摄入及孕中期增重与巨大儿的发生密切相关。结论进一步加强对孕妇的营养教育,定期监测孕妇体重增长情况是保障良好妊娠结局的重要措施。     

Gestational Weight Gain,Early Pregnancy Maternal Adiposity Distribution,and Maternal Hyperglycemia

To estimate the effects of gestational weight gain (GWG), central adiposity and subcutaneous fat on maternal post-load glucose concentration, pregnant women [n = 413, 62 % black, 57 % with pregravid body mass index (BMI) ≥25] enrolled in a cohort study at ≤13 weeks gestation. GWG was abstracted from medical records. In a sub-sample of women (n = 214), waist circumference (WC), and biceps and triceps skinfold thicknesses were measured at enrollment. At 24–28 weeks gestation, post-load glucose concentration was measured using a 50-g 1-h oral glucose tolerance test. After adjustment for pre-pregnancy BMI, age, parity, race/ethnicity, smoking, marital status, annual family income, education, family history of diabetes, and gestational age of GDM screening, each 0.3-kg/week increase in weight in the first trimester was associated with a 2.2 (95 % CI 0.1, 4.3)-mg/dl increase in glucose concentration. Each 8.6-mm increase in biceps skinfold thickness and each 11.7-mm increase in triceps skinfold thickness was associated with 4.3 (95 % CI 0.2, 8.5)-mg/dl increase in maternal glucose, independent of BMI and other confounders. Neither GWG in the second trimester nor WC at ≤13 weeks was significantly associated with glucose concentration after confounder adjustment. Independent of pre-pregnancy BMI, high early pregnancy GWG and maternal subcutaneous body fat may be positively associated with maternal glucose concentrations at 24–28 weeks.     

亚热带地区哺乳妇女能量需要量的观察

以同地区的53名非哺乳育龄妇女作对照,对262名产后0～6月乳母的体重、皮脂、上臂围、基础代谢率(BMR)、能量消耗和摄入量分别进行横向和纵向观察。结果表明,产后乳母体重和皮脂厚度逐渐下降,至第4个月基本稳定,平均减重4.2kg,估计孕期的贮脂大部分已消耗。上臂围无明显变化(P>0.05)。乳母的BMR在产后第1周较高(P<0.01),1～6月无明显变化(P<0.05),但比对照组高4～20％(P<0.05)。乳母在同一标准活动耗能与对照组接近(P>0.05)。轻体力劳动乳母日均活动耗能8.360MJ,估计泌乳耗能为2.807MJ/d。乳母能量摄入量比对照组多2.259MJ/d。作者认为,亚热带产后0～6月乳母在正常哺乳情况下,头4个月每日能量需要量应在平日消耗量基础上增加1.883MJ(450kcal),后雨月增加2.720MJ(650kcal),或整个阶段平均增加2.092MJ/d(500kcal/d),但此值仍需按泌乳量和正常体重变化加以调节。     

A longitudinal study of maternal anthropometric changes in normal weight, overweight and obese women during pregnancy and postpartum

Many women associate one or more of their pregnancies with the development of adult obesity. Such an association has not been fully explored. This longitudinal study examines the changes in maternal anthropometric indices during pregnancy and postpartum. Seventy-seven pregnant subjects were investigated longitudinally at about 13, 25 and 36 weeks gestation, of whom forty-seven continued taking part into the postpartum period. Maternal weight, height and skinfold thickness (triceps, biceps, subscapular, suprailiac and mid thigh) were measured at each visit. Maternal fat mass was estimated from the conversion of the first four skinfold thicknesses. Maternal waist and hip circumferences were also measured at the first visit and 6 weeks and 6 months postpartum. Weight and fat gain during pregnancy (13-36 weeks gestation) was 10.9 (SD 4.7) kg and 4.6 (SD 3.3) kg (P < 0.001) respectively. A significant increase in fat mass from 13 weeks gestation to 6-months postpartum was observed (2.6 (SD 4.5), P < 0.001). The increased weight at 6-months postpartum, however, was not statistically significant (1.1 (SD 6.0) kg, P = 0.20). Based on BMI in early pregnancy, the subjects were divided into groups of underweight, normal weight, overweight and obese. The last three groups were compared using ANOVA. The obese group showed a significant difference in the pattern of changes in the skinfold thickness, waist:hip ratio and fat mass at the postpartum period, in comparison with the other two groups. In conclusion, there is a tendency in the obese group to develop central obesity at the postpartum period.     

UAE population reference standard charts for body mass index and skinfold thickness,at ages 0–18 years

Aims To determine a range of anthropometric measurements including skinfold thickness measurements in four different areas of the body, to construct population growth charts for body mass index (BMI), skinfolds, and to compare these with growth charts from other countries. One aim was also to validate body fat charts derived from skinfold thickness.

Methods A national cross-sectional growth survey of children, 0–18 years old, was conducted using multistage stratified random sampling. The sample size included at least 200 children in each age–sex group. Height, weight, biceps skinfold, triceps skinfold, subscapular skinfold, suprailiac skinfold, and mid-upper-arm circumference were measured in each child. We describe correlation, standard deviation scores relative to the other standards, and calculation of body density in the United Arab Emirates population. We determined whether any of the above is a good indicator of fatness in children.

Results BMI, upper-arm circumference, sum of four skinfolds, and percentage body fat charts were constructed using the LMS method of smoothing. BMI was very significantly correlated with sum of skinfold thicknesses, and mid-upper-arm circumference. Prevalence of obesity and overweight in ages 13–17 years was respectively 9.94% and 15.16% in females and 6.08% and 14.16% in males. Derived body fat charts were found not to be accurate

Conclusion A national BMI, upper-arm circumference, and sum of four skinfolds chart has been constructed that can be used as a reference standard for the United Arab Emirates. Sum of four skinfold thickness charts can be used as crude determinants of adiposity in children, but derived body fat charts were shown to be inaccurate.     

Selective supplementation in pregnancy: effect on birth weight

Four-hundred and twenty-three pregnant women were admitted to this study which was designed to see whether birth weight could be increased by giving nutritional supplements to pregnant women who are nutritionally at risk, as proposed by Viegas et al in 1982. Selection was made by measuring change in the mean triceps skinfold thickness (MTST) between 18 and 28 weeks of pregnancy. Seventy-eight European and 80 Asian women failed to increase their MTST in mid trimester; half the women in each racial group were supplemented with a milk-based product yielding 407 kcal and 14.6 g protein daily from the 28th week of pregnancy until delivery.
Supplementation did not increase the mean birth weight; the babies of the supplemented women weighed 3.10 + 0.37 (mean ±2 s.d.) kg compared with the babies of comparable unsupplemented women which weighed 3.19 ±0.40 kg (corrected for maternal height and weight, parity, gestation at delivery and infants sex). Comparison of the corrected birth weight of the babies of unsupplemented women with MTST increase of ±6.2 mm between 18 and 28 weeks gestation and those with an MTST increase ±0.2 mm in the same 10 weeks showed no significant difference whether all races were analysed together or Europeans and Asians were analysed separately. Triceps skinfold thickness change therefore did not select women who were nutritionally at risk.     

Anthropometric measurements in the elderly population of Santiago, Chile

OBJECTIVE: There are few studies on anthropometry and nutritional status in large and representative samples of elderly populations in Chile and South America. We describe age and sex differences in weight, height, body mass index, knee height, waist circumference, midarm circumference, triceps skinfold thickness, arm muscle area, and calf circumference in Chilean elderly subjects. METHODS: This was a population-based, cross-sectional study. A total of 1220 elderly persons (819 women and 411 men; age range, 60-99 y) were recruited in the city of Santiago (Chile) through a probabilistic sampling procedure carried out from October to December 1999. RESULTS: Men were significantly heavier and taller than women in all age groups, whereas body mass index values were significantly higher in women than in men. All anthropometric variables showed a decrease in average values with aging in men and women. The apparent negative slopes for the decline in average values of body weight with aging was of greater magnitude in women than in men (-0.42 kg/y and -0.54 kg/y in male and female subjects, respectively). However, significant age x sex interaction was detected only for triceps skinfold thickness. In women, quadratic terms for age provided a significantly better fit than did the simple linear model for the association between age and weight, body mass index, waist circumference, triceps skinfold thickness, calf circumference, or midarm circumference. CONCLUSION: These observations indicated that body weight changes associated with aging might be more severe in Chilean women than in men, probably determining a differential pattern of lean and fat mass loss.     

中老年人身体脂肪含量的测定

用排水法和皮褶厚度法对55～69岁的115名中老年人体脂含量进行了测量和比较,结果表明,两种方法测得值差异有显著性。用前一种方法测值与体围指标(X_1:前臂围、X_2:上臂围、X_3:小腿围,X_4:大腿围、X_5:腹围、X_6:臀围)、BMI(Body mass index)建立测体脂含量(F％)的回归方程,男性F％=-15.88+1.37BMI+0.0102Y,女性为:F％=-34.96+0.51BMI+0.1469Y,其中Y为X_1+X_2+X_3+X_4+X_5+X_6之和,BMI=体重(kg)/身高(m~2)。该回归方程提供了测定中老年人体脂含量的简易方法。 将体脂含量百分比(F％)划分肥胖法与按超体重百分比和BMI划分肥胖法进行比较,结果是:超体重百分比法划分肥胖率较F％法低,BMI法则较F％法高。     

成人BMI与体脂含量和脂肪分布的关系

目的 :　调查成人超重和肥胖的发生率 ,探讨体质指数 ( BMI)与体脂含量、腰臀围之间的关系。方法 :　对 1 0 0 5名健康成年人进行人体测量 ,按 WHO对亚洲成年人的 BMI新定义分为 5组 ,对腰围、臀围、腰臀围比值和生物电阻抗法 ( BIA法 )及皮褶厚度法体脂含量的分布进行分析。结果 :　以 BMI法判断超重和肥胖的发生率 ,男性超重率和 度肥胖率明显高于女性 ,男女人群中 度肥胖发生率均较低 ;在相同 BMI组中 ,男性的平均年龄比女性低 ( P<0 .0 1 )。而 BIA法和皮褶厚度法肥胖检出率明显低于 BMI法 ,且女性体脂含量、三头肌皮褶厚度及肩胛下皮褶厚度显著高于男性。不同年龄组 BMI均与体脂含量呈显著正相关。女性超重组的腰围平均值为 80 cm,而男性 度肥胖组的腰围平均值 >90 cm。结论 :　男性超重和肥胖发生的年龄早于女性。以 BMI法判断肥胖和以 BIA法及皮褶厚度法体脂含量法判断肥胖有很大差别 ,仅以 BMI判断肥胖不够准确 ,尚需考虑年龄、性别及运动情况等影响因素。     

Body fat assessed from body density and estimated from skinfold thickness in normal children and children with cystic fibrosis

Body density and skinfold thickness at four sites were measured in 140 normal boys, 168 normal girls, and 6 boys and 7 girls with cystic fibrosis, all aged 8-14 y. Prediction equations for the normal boys and girls for the estimation of body-fat content from skinfold measurements were derived from linear regression of body density vs the log of the sum of the skinfold thickness. The relationship between body density and the log of the sum of the skinfold measurements differed from normal for the boys and girls with cystic fibrosis because of their high body density even though their large residual volume was corrected for. However the sum of skinfold measurements in the children with cystic fibrosis did not differ from normal. Thus body fat percent of these children with cystic fibrosis was underestimated when calculated from body density and invalid when calculated from skinfold thickness.     

Anthropometric studies on African athletes who participated in the 1st African University Games

1. Height, weight, skinfold thicknesses and mid-arm circumference were measured in 540 males and 117 females aged 20-24 years who took part in the 1st African University Games, held at the University of Ghana, Legon. Body fat content, Quetelet's index (weight divided by height X 100; Khosla & Lowe (1967)) and mid-arm muscle circumference were derived from the measurements taken. 2. The physique or body-build of the subjects as assessed by Quetelet's index showed that both male and female subjects from the various countries were of medium body-build. The body fat content for males was between 10 and 12% with the exception of the Egyptians (12.8%) while that of females was between 23-24%. 3. Body measurements of the subjects compared favourably with that of international standards (WHO, 1966) with the exception of the triceps skinfold thickness which was only approximately 60% of the standard value. 4. The low values for triceps skinfold thickness are probably due to differences in the distribution of subcutaneous fat at different sites in the body as found between caucasian and non-caucasian population groups. The results are discussed in relation to the findings of other workers on ethnic differences in skinfold thickness.