妊娠早中期实施营养运动和体重控制指导对新生儿结局的影响

目的:分析妊娠早中期进行孕期营养、运动和体重控制的产前指导对于新生儿结局的影响.方法:本研究采用整群抽样进行回顾性队列研究.观察组为妊娠早中期参加营养、运动和体重控制的产前课程,并在2019年10月31日前分娩单胎活产新生儿的孕妇;对照组为2018年同样时间段分娩单胎活产新生儿的孕妇,并在妊娠中晚期参加以上课程,比较两组新生儿的结局指标.结果:观察组巨大儿发生率为3.6%,而对照组为5.2%,差异有统计学意义(P=0.003).对于高龄孕妇,观察组与对照组小于胎龄儿发生率分别为5.2%和7.5%,差异有统计学意义(P=0.031).观察组早产儿发生率高于对照组,但控制年龄因素后,两组间差异无统计学意义(P=0.073).结论:妊娠早中期进行孕期营养、运动和体重控制的产前教育,能够降低新生儿出生体重异常的发生率.

Effect of the guidance of nutrition,exercise and weight control in the first and second trimester on neonatal outcomes

Objective:To analyze the effect of prenatal guidance on nutrition,exercise and weight control in the first and second trimester of pregnancy on neonatal outcomes.Methods:A retrospective cohort study method of cluster sampling was used.The parturient women who received regular prenatal examinations and delivered single live births in our hospital were recruited in the study.The observational group were the cases who delivered the baby before October 31th 2019 when nutrition,exercise and weight-control class had changed into the first and second trimester,the control group were the cases who delivered the baby in the same months in 2018 when such classes were held in the second and third trimester.The neonatal outcomes of the two groups were compared.Results:Compared with the control group(5.2%),the observation group(3.6%)had significantly lower incidence of macrosomia(P-0.003).For the pregnant women of advanced maternal age,the observation group(5.2%)had significantly lower incidence(P=0.031)of SGA(small for gestational age infant)than the control group(7.5%).The incidence of preterm newborn in the observation group was higher than the control group,but the difference was not statistically significant after controlling for the age(P=0.073).Conclusion:Nutrition,exercise and weight control education in the first and second trimester could reduce the incidence of birth weight abnormalities in newborns.