巨大儿发生的影响因素及妊娠结局分析

摘要

目的：探讨巨大儿发生的危险因素，为临床孕期监控及营养干预提供依据。方法：选取足月单胎妊娠孕妇，巨大儿组(新生儿体重≥4000 g)218例，对照组(新生儿体重2500~4000 g)200例，对其孕期资料及妊娠结局进行分析。结果：巨大儿组孕妇的孕前BMI、孕期体重增长、分娩男性新生儿的比例及妊娠期糖尿病的发病率均高于对照组(P<0.05)；巨大儿组产妇剖宫产率明显高于对照组(P<0.05)，且产后出血量亦显著高于对照组(P<0.05)。结论：孕妇的孕前BMI、孕期体重增长、胎儿性别、妊娠期糖尿病与巨大儿发生有关。巨大儿增加手术产率，易发生产后出血，积极有效的孕期监控，预防巨大儿的发生对于提高产科质量具有重要意义。%Objective:To find effect factors of macrosomia,then providing clinical basis for nutritional intervention in pregnancy.Method:218 cases who delivery macrosomia infant(body mass≥4000 g) in our hospital were selected,and 200 cases whose newborns had normal birth weight(2500-4000 g) were selected as control.Result:The maternal BMI before pregnancy,weight gain in pregnancy,male fetus and gestational diabetes mellitus rates were significant higher in macrosomia group than those in control group(P<0.05).The cesarean section rate was significant higher in macrosomia group than that in control group(P<0.05), and the volume of postpartum hemorrhage was significant increased in macrosomia group than that in control group(P<0.05).Conclusion:Maternal BMI before pregnancy,weight gain in pregnancy,fetal gender and gestational diabetes mellitus are relative factors of macrosomia.Macrosomia increases cesarean section and postpartum hemorrhage rates.Positive and effective nutritional intervention in pregnancy are important for prevent macrosomia occur and improve perinatal outcome.