文章摘要
李艳华,陈小梅,陈水仙,吴江南,卓秀云,郑巧玲,危秀青,张蓉华,黄慧卿,郑翠仙,林娟.孕前体重和孕期增重对新生儿出生结局及孕产妇围产结局的影响[J].中华流行病学杂志,2014,35(6):635-640
孕前体重和孕期增重对新生儿出生结局及孕产妇围产结局的影响
A cohort study on the impacts of pre-pregnancy maternal body mass index,gestational weight gain on neonate birth status and perinatal outcomes in Fujian province
投稿时间:2013-11-10  
DOI:
中文关键词: 妊娠结局;孕前体重;孕期增重;随访研究;影响因素
英文关键词: Pre-pregnancy maternal body mass index;Gestational weight gain;Pregnancy outcomes;Cohort study;Impact factors
基金项目:福建省妇幼保健院科研基金(2010-18)
作者单位E-mail
李艳华 350001 福州, 福建省妇幼保健院 fjcsqx@sina.com 
陈小梅 350001 福州, 福建省妇幼保健院  
陈水仙 350001 福州, 福建省妇幼保健院  
吴江南 福建省疾病预防控制中心  
卓秀云 350001 福州, 福建省妇幼保健院  
郑巧玲 350001 福州, 福建省妇幼保健院  
危秀青 350001 福州, 福建省妇幼保健院  
张蓉华 350001 福州, 福建省妇幼保健院  
黄慧卿 350001 福州, 福建省妇幼保健院  
郑翠仙 350001 福州, 福建省妇幼保健院  
林娟 350001 福州, 福建省妇幼保健院  
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中文摘要:
      目的 探讨孕前体重和孕期增重对妊娠结局的影响。方法 采用前瞻性队列研究和整群抽样,对福建省妇幼保健院围产营养门诊既往无高血压、糖尿病、血脂异常等病史,且本次妊娠未发现心脏、肝脏、肾脏、甲状腺等器官疾病的单胎妊娠孕妇进行问卷调查,追踪其围产过程并发症、分娩方式及新生儿出生结局等。采用相关分析、χ2检验和logistic 回归分析孕前体重、孕期增重与妊娠结局的关系。结果 623 名孕妇纳入分析592 名(95%)。多因素logistic 回归分析显示,在控制相关混杂因素后,相比孕前适宜体重孕妇(BMI 18.5~24.0 kg/m2),孕前低体重(BMI<18.5 kg/m2)是低出生重量指数(PI)的危险因素(OR=2.34,95%CI:1.24~4.42),孕前超重(BMI>24.0 kg/m2)是高出生PI 的危险因素(OR=2.73,95%CI:1.12~6.68)。相比孕期增重适宜(孕期增重P15~P85)、增重不足(孕期增重<P15)的孕妇,发生早产、低出生体重儿、妊娠糖尿病和低出生PI的OR 值(95%CI)分别为4.85(1.35~17.51)、10.30(2.29~46.35)、2.29(1.07~4.93)和2.65(1.24~5.68);孕期增重过多孕妇(孕期增重>P85)生产巨大儿、高出生PI 和妊娠糖尿病的OR值(95%CI)分别为3.83(1.74~8.44)、2.39(1.14~5.01)和2.21(1.07~4.55)。结论 孕前低体重和超重均影响新生儿出生PI。孕期增重不足是早产、低出生体重儿、妊娠糖尿病和低出生PI 的危险因素,孕期增重过多是高出生PI 和妊娠糖尿病的危险因素。
英文摘要:
      Objective To study the impacts of pre-pregnancy maternal BMI and gestational weight gain(GWG)on pregnancy outcomes. Methods We adopted a prospective cohort study with cluster sampling in single pregnant women,who were not with hypertension,diabetes,hyperlipidemia or other diseases in the previous history,neither did they have diseases of heart,liver,kidney,thyroid etc. related to current pregnancy. Those pregnant women who visited the prenatal nutrition clinic under ‘informed consent’were surveyed with questionnaire to track their peri-natal complications,delivery mode and neonate birth outcomes etc. Pearson and partial correlations,chi-square test and binary logistic regression were used to study the association between pre-pregnancy maternal BMI,GWG and pregnancy outcomes. Results A total of 623 pregnant women were recruited in the cohort,with 592(95%)of them eligible for analysis. Results from the Multivariate Logistic Regression analysis indicated that,after controlling the potential confounding factors,when compared to women with pre-pregnancy BMI between 18.5 and 24.0,the odds ratios(ORs)for low birth ponderal index(PI) were 2.34[95% confidence interval(CI),1.24-4.42)]among those with BMI<18.5,respectively,while 2.73(1.12-6.68)for high birth PI among those with BMI>24.0. Similarly,when compared to pregnant women with normal GWG(defined as weight gain range from P15 to P85 by stratification of pre-pregnancy BMI),low GWG(<P15)seemed to be the risk factor for preterm birth,low birth weight,gestational diabetes mellitus,with low birth PI [ORs as 4.85(1.35-17.51),10.30 (2.29-46.35),2.29(1.07-4.93) and 2.65(1.24-5.68),respectively. High GWG(>P85)appeared the risk factor for high birth weight,high birth PI,and gestational diabetes mellitus,with ORs as 3.83(1.74-8.44),2.39(1.14-5.01)and 2.21(1.07-4.55),respectively. Conclusion Low or high pre-pregnancy maternal BMI and GWG were associated with adverse pregnancy outcomes.
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