中国城市人群孕期体重增加及其与新生儿出生体重的关系:一项多中心横断面研究

 目的 根据美国医学研究院(Institute of Medicine,IOM)2009年指南标准,调查中国人群低危孕产妇孕前体质指数(body mass index,BMI)和孕期体重增加(gestational weight gain,GWG)及其与新生儿出生体重的关系。方法 本研究采用多中心、大样本的横断面调查的方法,在14个省市39家医院连续时间段分娩的孕产妇的112 485例资料中,选择无并发症、单胎、关键数据完整的28周后分娩的低危妊娠女性54 827例。分析产妇身高、孕前BMI、GWG等指标对出生体重的影响,并建立回归模型。结果 孕前平均BMI为21.3 kg/m2,孕前BMI在正常范围的女性比例为77.2%,低体重女性比例为12.9%,超重为9.0%,肥胖为0.8%。平均GWG为(14±5)kg,根据IOM的标准,GWG总达标率仅45%,未达标者26%,超标者29%。出生体重与孕产妇身高、孕前BMI和GWG均有明显的正相关。结论 中国城市孕产妇的身高、孕前BMI不同于其他国家,GWG控制不理想。建立符合中国人群特点的孕期营养咨询策略对于降低巨大儿和低体重儿具有重要意义。

Gestational weight gain and its association with birth weight of newbron in the urban population of China:a multi-center cross-sectional survey

Objective  To explore associations among pre-pregnancy body mass index (BMI),gestational weight gain (GWG) and birth weight of newbron in a low risk population in China based on the 2009 Institute of Medicine (IOM) guidelines.Methods  This was a multicenter,cross-sectional study of 54 827 women.The sample for the study was selected from a total population of 112 485 women recruited from 39 hospitals in 14 provinces.The exclusion criteria were delivery<28 weeks of gestation,multiple pregnancies,complication during pregnancy and unavailability of full medical records.The associations of pre-pregnancy BMI,GWG and maternal height with birth weight were examined,and we constructed a regression model to predict birth weight.Results  The mean pre-pregnancy BMI was 21.3 kg/m2.Based on pre-pregnancy nutritional status assessed using BMI,the prevalence of underweight,normal weight,overweight,and obese women was 12.9%,77.2%,9.0%  and 0.8%,respectively. The mean GWG was (14±5) kg.According to the IOM criteria,26%,45% and 29% of women were respectively below,inside and above the normal GWG standard.There were significant positive correlations between birth weight and maternal height, and pre-pregnancy BMI and GWG.ConclusionsFor urban Chinese women,the maternal heightand the pre-pregnancy BMI had their own specific characteristics.The GWG control was not ideal.To establish a nutrition consulting strategy based on the characteristics of Chinese women may have an important role for reducing the risk of macrosomia and low birth weight infants.