健康孕妇足月新生儿出生体重相关影响因素研究

目的探讨影响健康孕妇新生儿体重的相关因素。方法本研究为前瞻性研究,选择2013年3-8月在青岛市市立医院检查并决定在本院分娩的早孕妇女480例,排除个别妊娠合并症和并发症,共376例进入研究,追踪调查至孕妇分娩。详细记录孕妇年龄、孕前体质量、身高、分娩孕周、分娩前体质量、孕期体质量增长、新生儿体质量,并检测妊娠32~34周孕妇血脂及血糖水平,分析各因素与新生儿体质量的相关性。结果孕期体质量增长、甘油三酯水平与新生儿体质量呈正相关（r=0.213,P〈0.01;r=0.244,P〈0.001）。甘油三酯与孕前体重指数、孕期体质量增长呈正相关（r=0.172,P〈0.05;r=0.178,P〈0.01）。巨大儿组孕妇甘油三酯水平为（3.82±1.47）mmol/L,正常儿组孕妇为（3.21±1.26）mmol/L,差异有统计学意义（P〈0.05）。巨大儿组孕妇空腹血糖水平为（4.45±0.063）mmol/L,正常儿组孕妇血糖水平为（4.17±0.50）mmol/L,差异有统计学意义（P〈0.01）。结论孕妇血脂、血糖水平及孕期增重显著影响新生儿出生体重,孕期应该平衡膳食、合理增重,并进行血脂、血糖监测,对控制新生儿的体重有重要的临床意义。

Study on influencing factors on birth weight of full term neonates in healthy pregnant women

Objective To study the influencing factors of neonatal birth weight in healthy pregnant women,and provide a basis for health care during pregnancy.Methods A total of 480 pregnant women during the first trimester from March2013 to August 2013 in Qingdao municipal hospital were selected as the participants.The subjects and their neonates were followed from pregnancy until delivery.All 376 valid healthy pregnant women who gave full term birth to single baby were classified and analyzed prospectively.Subjects had normal glucose metabolism and without pregnancy complications.The age,body height,gestational weeks,pregestational body weight,gestational weight gain,antepartum body mass index and neonatal birth weight were recorded.Fasting serum lipid and glucose of pregnant women at 32-34 weeks’ gestation were detected as well.Results The correlation analysis showed that the neonatal birth weight was positively related to gestational weight gain（r=0.213,P〈0.01） and triglyceride level（TG,r=0.244,P〈0.001）. TG level was positively related to pregestational body weight（r=0.172,P〈0.05） and gestational weight gain（r=0.178,P〈0.01）. The TG level（P〈0.05）and glucose level（P〈0.01） in fetal macrosomia group were significantly higher than those in the ideal weight groups.Conclusion Serum lipid level and blood glucose level of pregnant women and gestational weight gain can be important factors which influence the birth weight of neonates,so in order to control neonatal birth weight it was very important to advocate regular pregnancy checkups,balance diet,strengthen gestational management,keep appropriate weight gain,detect serum lipid and blood glucose timely,appropriately and effectively.