孕期总增重与不良妊娠结局关系的前瞻性研究

张亦奇; 兰茜; 张琚; 周容; 代正燕; 吴成; 鲍妍宏; 杨柳青; 周凤鸣; 赵蓉萍; 曾果

Abstract

张亦奇,兰茜,张琚,周容,代正燕,吴成,鲍妍宏,杨柳青,周凤鸣,赵蓉萍,曾果.孕期总增重与不良妊娠结局关系的前瞻性研究[J].Chinese journal of Epidemiology,2018,39(12):1626-1629

孕期总增重与不良妊娠结局关系的前瞻性研究

Association between gestational weight gain and adverse pregnancy outcomes: a prospective study

Received:April 15, 2018

DOI：10.3760/cma.j.issn.0254-6450.2018.12.017

KeyWord: 孕期增重妊娠并发症出生体重早产

English Key Word: Gestational weight gain Pregnancy complications Birth weight Preterm delivery

FundProject:中国营养学会孕期体重增长适宜值的多中心队列研究（CNS-2012-002）

Author Name	Affiliation	E-mail
Zhang Yiqi	Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
Lan Xi	Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
Zhang Ju	Department of Nutrition, Maternity and Child Health Care Central Hospital of Sichuan, Chengdu 610045, China
Zhou Rong	Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China
Dai Zhengyan	Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
Wu Cheng	Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
Bao Yanhong	Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
Yang Liuqing	Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
Zhou Fengming	Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
Zhao Rongping	Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China
Zeng Guo	Department of Nutrition, Food Hygiene and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China	zgmu2007@126.com

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Abstract:

目的探讨孕期总增重与不良妊娠结局之间的关系。方法选取成都市妇幼医疗机构产前门诊1 220名6~12孕周、单胎健康的妇女为研究对象进行前瞻性研究。通过问卷调查收集孕妇年龄、孕前体重等基本信息，于分娩前测量孕妇体重，计算孕期总增重，参照2009年美国医学研究所发布的孕期增重推荐标准将研究对象分为增重适宜、增重不足和增重过多组。于分娩后通过医院信息系统收集妊娠结局相关信息。采用多因素非条件logistic回归分析探讨孕期总增重与不良妊娠结局关系。结果共纳入1 045名单胎活产孕妇进行分析。与孕期增重适宜组相比，孕期增重过多组脐带缠绕和大于胎龄儿发生风险升高（分别为OR=1.641，95% CI：1.197~2.252和OR=1.678，95% CI：1.132~2.488）；孕期增重过少组早产发生风险升高（OR=3.189，95% CI：1.604~6.341）。结论孕期总增重过多和过少均可能导致不良妊娠结局。应重视孕期体重监测，降低不良妊娠结局发生风险。

English Abstract:

Objective To explore the association between gestational weight gain (GWG) and adverse pregnancy outcomes. Methods A prospective study was conducted among 1 220 healthy singleton pregnant women in the first trimester of pregnancy, from Chengdu city, Sichuan province. Pre-gestational body mass and other basic information were collected through a set of questionnaires. Weight at the last week before delivery was measured and GWG was classified by IOM criteria (2009). Related information on pregnancy outcomes was collected after delivery, through the hospital information system. Multiple non-conditional logistic regression models were used to test the association between GWG and adverse pregnancy outcomes. Results In total, data on 1 045 pregnant women were analyzed. Compared with adequate GWG, excessive GWG was associated with the increased risks of cord entanglement and large for gestational age (OR=1.641, 95% CI:1.197-2.252; OR=1.678, 95% CI:0.132-2.488), respectively. Additionally, when compared with the adequate GWG, insufficient GWG was associated with the increased risk of preterm delivery (OR=3.189, 95% CI:1.604-6.341). Conclusions Both excessive and insufficient GWG appeared associated with the pregnancy outcomes. Weight monitoring should be strengthened for pregnant women to reduce related risks on adverse pregnancy outcomes.

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