孕前体质指数对妊娠并发症和妊娠结局的影响

目的:探讨孕妇孕前体质指数(BMI)与妊娠期并发症、妊娠结局的关系。方法:以江西省贵溪市人民医院2010年8月～2011年10月住院分娩的单胎初产、足月妊娠妇女1 200例为对象,收集其围产保健、妊娠并发症和妊娠结局资料,参照中国肥胖问题工作小组标准将对象分为消瘦组(A组)、正常组(B组)、超重组(C组),分析孕前BMI与妊娠期高血压、糖尿病、贫血等妊娠并发症以及与新生儿出生体重、分娩方式、产后出血、新生儿窒息等不良妊娠结局的关系。结果:A、B、C组新生儿出生体重差异有统计学意义(P<0.01),产后出血、新生儿窒息发生率组间差异无统计学意义(P>0.05);孕前低BMI组孕晚期贫血率达到37.96%,低体重儿发生率达到5.55%,均显著高于其余两组(P<0.05);孕期超重组妊娠期高血压发生率7.52%,妊娠期糖尿病发病率为2.86%,巨大儿出生率为29.17%,剖宫产率44.80%,高于其余两组(P<0.05)。结论:孕前BMI影响妊娠期并发症及出生体重、分娩方式等,即使在中小城市问题亦比较严重,如何进行健康教育对促进母婴安全和健康有重要意义。

Effect of prepregnant body mass index on pregnancy complications and outcomes

Objective:To explore the relationship between prepregnant body mass index(BMI) of pregnant women and pregnancy complications and outcomes.Methods:A total of 1 200 pregnant women(single birth,primiparity,and full-term pregnancy) who hospitalized for delivery in Guixi People’s Hospital of Jiangxi Province from August 2010 to October 2011 were selected as study objects,the data of perinatal health care,pregnancy complications,and pregnancy outcomes were collected,and then the study objects were divided into thin group(group A),normal group(group B),and overweight group(group C) according to the criteria designed by China Obesity Workgroup,the relationship between prepregnant BMI and pregnancy complications(such as hypertensive disorder complicating pregnancy,diabetes mellitus,and anemia) and adverse pregnancy outcomes(such as neonatal birth weight,delivery modes,postpartum hemorrhage,and neonatal asphyxia) was analyzed.Results:There was statistically significant difference in neonatal birth weight among group A,group B,and group C(P<0.01),but there was no statistically significant difference in the incidences of postpartum hemorrhage and neonatal asphyxia among the three groups(P>0.05);in thin group,the incidences of anemia during the third trimester of pregnancy and low birth weight infants were 37.96% and 5.55%,respectively,which were statistically significantly higher than those in the other two groups(P<0.05);in overweight group,the incidences of hypertensive disorder complicating pregnancy and diabetes mellitus were 7.52% and 2.86%,respectively,the birth rate of macrosomia was 29.17%,the rate of cesarean section was 44.80%,which were statistically significantly higher than those in the other two group(P<0.05).Conclusion:Prepregnant BMI affects pregnancy complications,birth weight,and delivery modes,the problems in middle-sized and small cities are severe,health education has important significance for improving safety and health of mothers and infants.