妇女孕前体质量指数、孕期增重对子痫前期-子痫影响研究

目的 分析孕妇孕前体质量指数(BMI)、孕期各阶段增重、孕期总增重与子痫前期-子痫（PE-E)发生的相关性。方法 采用概率比例规模抽样法(PPS抽样)，招募西南三省5 396例单胎妊娠孕妇为研究对象，收集其一般人口学资料，测量获得其身高、孕前体质量、每次产前检查的体质量等指标，并计算孕期各阶段增重和孕期总增重。根据美国医学研究院(IOM)标准定义其孕期增重是否适宜。采用logistic回归分析孕前BMI、孕期增重指标与PE-E的关系。结果 与孕前BMI处于正常范围内的孕妇相比，孕前BMI较低者PE-E发生的可能性较低(OR=0.19，95%CI:0.03～0.62)，孕前超重、肥胖的孕妇发病风险增加(超重OR=3.69，95%CI:2.21～6.01；肥胖OR=6.12，95%CI:1.68～17.30)。孕中期增重速率过大(OR=2.24，95%CI:1.25～4.35)、妊娠期总增重过高者(OR=1.70，95%CI:1.02～2.85)发生PE-E的风险增加。结论 孕前BMI、孕期增重和PE-E的发生密切相关，育龄妇女孕前应尽量达到正常体质量标准，孕期保持适宜的体质量增加，以减少PE-E发生的可能性。

Pre-pregnancy body mass index,gestational weight gain and the risk of Preeclampsia-Eclampsia

To explore the correlation between preeclampsia-eclampsia(PE-E) and pre-pregnancy BMI, weight gain during each period of pregnancy and total gestational weight gain. Methods A total of 5396 women who delivered a live singleton between January 1, 2016 and December 31, 2016 in the three provinces in southwest of China were enrolled in this prospective cohort study by PPS sampling method. The general demographic characteristics were collected through questionnaire, and the height, pre-pregnancy weight and weight in every routinely prenatal care were collected by the qualified medical workers. And the weight gain during each period of pregnancy and total gestational weight gain were calculated. Whether the gestational weight gain was proper or not was determined by the criterion of the American Institute of Medicine(IOM). Multiple unconditional logistic regression was conducted to evaluate association between PE-E and pre-pregnancy BMI, gestational weight gain. Results Compared with their normal weight counterparts, pregnant women whose pre-pregnancy BMI were lower than the recommendation weres less likely to suffer from preeclampsia(OR=0.19,95%CI:0.03-0.62), and pregnant women who were overweight or obese before pregnancy had an elevated risk of developing preeclampsia(overweight: OR=3.69, 95%CI:2.21-6.01; obese: OR=6.12,95%CI:1.68-17.30). Women whose weight gain during the second trimester(OR=2.24,95%CI 1.25-4.35) or the total gestational weight gain(OR=1.70, 95%CI 1.02-2.85) were higher than the IOM recommendation were more likely to suffer from PE-E. Conclusion The results from this study show that maternal pre-pregnancy BMI and total GWG are both positively associated with the risk of preeclampsia. Women among childbearing age should try to reach the recommended weight before pregnancy and maintain proper weight gain during pregnancy so as to reduce the risk of preeclampsia.