孕前体质指数、孕期增重与子代出生体重的关系

目的 探讨孕前体质指数、孕期增重与子代出生体重的关系.方法 选取在妇幼保健机构体检的婴儿母亲,采用问卷调查的方式收集母亲的一般情况、孕期增重及子代出生体重、身长等情况.采用方差分析、x2检验和多因素Logistic回归模型等方法进行数据统计分析.结果 母亲孕前超重/肥胖的检出率为12.3%(199例),孕期增重过高的检出率为52.1%(842例).超重/肥胖组其子代出生体重、巨大儿和大于胎龄儿的发生率均较高(P<0.05),而子代的出生体重、巨大儿发生率、低体重儿发生率、小于胎龄儿发生率以及大于胎龄儿发生率均在孕期增重过高组,增重适宜组和增重不足组间存在差异(P<0.05).在控制了母亲年龄等因素后,孕前超重/肥胖增加了巨大儿(OR=1.7, 95% CI:1.2~2.6)、大于胎龄儿(OR=1.7,95% CI:1.1~2.5)的发生风险,孕期增重过高则增加了巨大儿(OR=1.7,95% CI:1.2~2.5)、大于胎龄儿(OR=1.7,95% CI:1.1~2.4)的发生风险.而孕期增重不足能增加低体重儿(OR=2.2,95% CI:1.1~4.4)、小于胎龄儿(OR=2.0,95% CI:1.2~3.4)的发生风险.结论 母亲孕前体质量指数及孕期增重均与巨大儿和大于胎龄儿的发生密切相关,且孕期增重不足与低体重儿和小于胎龄儿的发生也密切相关.孕期保健应该加强对孕妇体重的监测,防止其对新生儿出生结局产生不良影响.

Relationship between pre-pregnancy bodymass index,gestational weight gain and birth weight

Objective To investigate the association between pre-pregnancy body mass index, gestation weight gain(GWG) and birth weight.Methods With informed consent, we recruited mothers whose child received regular physical examinations.All participants were asked to complete the self-administered questionnaires to collect infor-mation of maternal sociodemographic characteristics, weight gain during pregnancy and fetal birth weight, birth height.Statistical analysis was processed by analysis of variance, c2 test and multivariate Logistic regression models.Results The prevalence of pre-pregnancy overweight /obesity were 12.3%(199) and excess gestational weight gain were 52.1%(842).Fetal birth weight, incidence of macrosomia and large for gestational age among mother who were of pre-pregnancy overweight /obesity were better than mothers who were of normal weight(P<0.05).And fetal birth weight, incidence of macrosomia, low birth weight, small for gestational age and large forgestational age among mother who were of excess gestational weight gain were better than mothers who were of normal weight gain.After controlling the factors such as maternal age, education level of pregnant women and their husbands, pre-pregnancy overweight /obesity could increase the rates of macrosomia(OR=1.7, 95% CI:1.2~2.6) and large for gestational age(OR=1.7,95% CI:1.1~2.5), and excess gestational weight gain was associated with the rates of macrosomia(OR=1.7, 95% CI:1.2~2.5) and large for gestational age(OR=1.7, 95% CI:1.1~2.4).But low gestational weight gain could increase the risk of low birth weight(OR=2.2, 95% CI:1.1~4.4) and small for gestational age(OR=2.0, 95% CI:1.2~3.4).Conclusion Both pre-pregnant BMI and gestation weight gain are associated with macrosomia and large for gestational age, and low gestational weight gain are associated with low birth weight and small for gestational age.Strengthening the monitoring for weight gain during pregnancy should be attached to health care during pregnancy to prevent potential adverse effects on birth outcomes.