体重指数对初产妇妊娠结局的影响

目的 探讨体重指数(BMI)对初产妇妊娠结局的影响.方法 选择于我院正规产检及分娩的800例初产妇,根据孕前BMI将其分为3组:消瘦组(BMI＜ 18.0 kg/m2)、正常体重组(BMI 18.0～23.9 kg/m2)及超重组(BMI≥24 kg/m2),观察孕前BMI对妊娠结局的影响;根据孕期BMI增长将其分为3组:A组:BMI增长＜5,B组:BMI增长5～7,C组:BMI增长＞7;进一步分析孕期BMI增长对妊娠结局的影响.结果 孕前超重组巨大儿发生率及剖宫产率明显高于正常组与消瘦组[巨大儿发生率分别为10.6％(7/66)、5.7％(39/682)、3.8％(2/52),剖宫产率分别为60.6％(40/66)、46.8％(319/682)、40.4％(21/52)],差异有统计学意义(P＜0.05,P＜0.01);孕期BMI增长＞7者,巨大儿发生率及剖宫产率明显高于BMI增长＜5及BMI增长5～7者[巨大儿发生率分别为10.7％(30/280)、1.3％(2/152)、4.3％(16/368),剖宫产率分别为[62.5％(175/280)、39.5％(60/152)、39.4％(145/368)],差异有统计学意义(P均＜0.05);3组产后出血的发生率及阴道分娩产程差异均无统计学意义(P均＞0.05).结论 孕前超重及孕期BMI增长过多对初产妇分娩方式及巨大儿发生具有显著影响.

The effects of body mass index on the outcomes of childbirth in the primipara

Objective To study the effect of body mass index(BMI)on the outcomes of women on their childbirth.Methods 800 women on their childbirth were divided into three groups(thin group,normal group and overweight group)according to their pre-pregnancy BMI.We evaluated the relationship of pregnancy BMI and childbirth outcomes.Meanwhile,in order to analyze the relationship between childbirth outcomes and the increase of BMI during pregnancy,these women were divided into another three groups(group A,BMI increased by ＜5; group B,BMI increased by 5 ～7; group C,BMI increased by ＞7).The relationship between BMI increase during pregnancy and outcomes of pregnancy was investigated.Results The rates of macroeosmia and cesarean section in overweight group were statistically higher than that in thin group and normal group.The difference in these rates was not statistically significant between normal group and thin group.In women with big BMI increase during pregnancy,the incidences of macrocosmia and cesarean section were statistically significantly higher than that of the other two groups(P ＜ 0.05).No difference was found for the rates of postpartum hemorrhages,labor durations of vaginal delivery between the three groups.Conclusion Prepregnancy overweight and high BMI increase have significant influence on the rates of macrocosmia and cesarean section in primipara.