哈密维吾尔族女性孕前BMI及孕期体重增长对妊娠过程及结局的影响

摘要

Objective To investigate the relationship between pre-pregnancy body mass index (BMI),gestational weight gain (GWG),and pregnancy complications,adverse outcomes of Hami uygur women.Methods A total of 428 single birth pregnant women received routine antenatal care in the Department of Obstetrics and Gynecology of Hongxing Hospital,Xinjiang Hami Agricultural Division 13 from December 2016 to November 2017.SPSS 22.0 software was used to analyze the relationship between pre-pregnancy BMI,GWG,and pregnancy complications,pregnancy outcomes.Results The average GWG of 428 pregnant women was (18.0±4.9)kg,the average neonatal birth weight was (3 441.6±487.6) g.(1) The rates of pregnancy-induced hypertension (PIH),gestational diabetes mellitus (GDM),macrosomia,cesarean section,postpartum hemorrhage,and neonatal asphyxia in obesity and overweight group were significantly higher than those in underweight and normal group (P＜0.05).According to the GWG group during pregnancy recommended by IOM,the rates of PIH,GDM,macrosomia,cesarean section in high GWG group were significantly higher than those in low GWG group and normal GWG group (P＜0.05),the rate of infant of low-birth weight in low GWG group was significantly higher than those in high GWG group and normal GWG group (P＜0.05).(2) Pre-pregnancy overweight and obesity group were more likely to have GDM (OR=1.99,OR=2.04),PIH (OR=2.39,OR=3.98),macrosomia (OR=1.70,OR=2.95),cesarean section (OR=2.01,OR=2.47),postpartum hemorrhage (OR=1.98,OR=2.37),and neonatal asphyxia (OR=3.36,OR=7.05).High GWG group was more likely to have PIH (OR=1.78),GDM (OR=2.10),macro somia (OR=3.16),cesarean section (OR=1.43),whereas low GWG group was more likely to have infant of low-birth weight (OR=5.29).Conclusion The pre-pregnancy BMI and GWG not only affect the occurrence of pregnancy-associated diseases,have a close relationship with pregnancy outcomes of uygur women.%目的 探讨哈密维吾尔族女性孕前体质指数(BMI)及孕期体重增长(GWG)与妊娠合并疾病及不良妊娠结局的影响.方法 选取2016年12月至2017年11月在新疆生产建设兵团第十三师红星医院产科门诊定期产前检查并住院分娩的428例足月单胎维吾尔族初产妇的临床资料,分别将产妇按孕前体质指数(BMI)和不同孕期体重增长(GWG)分组,采用SPASS22.0软件进行分析孕前体质指数及孕期体重增长与妊娠合并疾病及结局的关系.结果 维吾尔族孕妇孕期体重平均增加(18.0±4.9) kg,新生儿平均出生体重(3 441.6±487.6)g.①肥胖组和超重组妊娠高血压、糖尿病、巨大儿、剖宫产、产后出血及新生儿窒息的发生率明显高于低体重组和正常组(P＜0.05).根据IOM推荐孕期GWG分组,超GWG组妊娠高血压、糖尿病、巨大儿、剖宫产的发生率明显高于低GWG及正常GWG (P＜0.05),而低GWG的低体重儿的发生率明显高于正常组和超增重组(P＜0.05).②孕前超重、肥胖能增加妊娠期糖尿病(OR=1.99,OR=2.04)、妊娠期高血压疾病(OR=2.39,OR=3.98)、巨大儿(OR=1.70,OR=2.95)、剖宫产(OR=2.01,OR=2.47)、产后出血(OR=1.98,OR=2.37)、新生儿窒息(OR=3.36,OR=7.05)的发生风险,超GWG增加妊娠期高血压(OR=1.78)、妊娠期糖尿病(OR=2.10)、巨大儿(OR=3.16)、剖宫产(OR=1.43)的发生风险,而低GWG会增加低体重儿(OR=5.29)的发生风险.结论 维吾尔族妇女孕前BMI和及孕期GWG不仅影响妊娠合并疾病的发生,也与妊娠结局密切相关.