基于孕前体质指数的孕期适宜增重范围初步评估
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摘要
目的以减少巨大儿的发生、降低剖宫产率和出血量及母婴并发症为目的,基于孕妇孕前体质指数(BMI)得出研究区域内人口相对应的孕期适宜的增重范围。方法研究对象为2013年1月1日至2013年12月31日在上海市闵行区中心医院和闵行区妇幼保健院产科门诊建卡并住院分娩的孕妇,通过电子病历系统和区域电子随访系统收集孕期体重变化、妊娠相关指标和妊娠结局数据。以回顾性的研究方法,统计分析上海闵行地区人群中,基于孕前体质指数的孕期适宜增重范围。结果上海市闵行地区的妊娠妇女巨大儿发生率为8.73%,结合三大不良妊娠结局得到新生儿适宜出生体重介于2 900~3 499 g之间。孕前BMI低于18.5的偏瘦型妇女孕期适宜增重范围为10~17 kg;孕前BMI介于18.5~23.9之间的正常体形的孕妇孕期适宜增重宜控制在8~15 kg;孕前BMI大于等于24的超重孕妇孕期增重最好能控制在7~15 kg之间。结论推荐偏瘦、正常和超重孕妇的妊娠期适宜增重范围分别为10.0~17.0kg、8.0~15.0 kg和7.0~15.0 kg。孕期增重控制在相应的适宜范围内,有利于获得最佳妊娠结局。
Objective To establish the guidelines for gestational weight gain on the basis of pre-pregnancy BMI in order to avoid the occurrence of macrosomia and to reduce cesarean section rate,amount of bleeding and maternal and infantile complications. Methods The pregnant women did antenatal examination and delivered in these 2 hospitals during Jan 1,2013 to Dec 31,2013 were allocated in this study. According to the neonatal birth weight,cesarean section rate,amount of bleeding and maternal and infant complications,the guideline for pregnancy weight gain on the basis of pre-pregnancy BMI. Results The incidence of macrosomia in Shanghai Minhang District was 8. 73%. The range of appropriate birth weight was between 2. 9 kg to 3. 499 kg. The recommended range for gestational weight gain was among 10 ~ 17 kg,8 ~ 15 kg and 7 ~ 15 kg for pregnant women with pre-pregnancy BMI < 18. 5,18. 5≤BMI < 24 and BMI≥24 respectively. Conclusion The recommended ranges for pregnancy weight gain are 10. 0 ~ 17. 0 kg,8. 0 ~ 15. 0 kg and 7. 0 ~ 15. 0 kg respectively,which would be beneficial for the best outcome of pregnancy.
Objective To establish the guidelines for gestational weight gain on the basis of pre-pregnancy BMI in order to avoid the occurrence of macrosomia and to reduce cesarean section rate,amount of bleeding and maternal and infantile complications. Methods The pregnant women did antenatal examination and delivered in these 2 hospitals during Jan 1,2013 to Dec 31,2013 were allocated in this study. According to the neonatal birth weight,cesarean section rate,amount of bleeding and maternal and infant complications,the guideline for pregnancy weight gain on the basis of pre-pregnancy BMI. Results The incidence of macrosomia in Shanghai Minhang District was 8. 73%. The range of appropriate birth weight was between 2. 9 kg to 3. 499 kg. The recommended range for gestational weight gain was among 10 ~ 17 kg,8 ~ 15 kg and 7 ~ 15 kg for pregnant women with pre-pregnancy BMI < 18. 5,18. 5≤BMI < 24 and BMI≥24 respectively. Conclusion The recommended ranges for pregnancy weight gain are 10. 0 ~ 17. 0 kg,8. 0 ~ 15. 0 kg and 7. 0 ~ 15. 0 kg respectively,which would be beneficial for the best outcome of pregnancy.
引文
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[7]蒋一方,金焱,林钟芳,等.3种孕期增重曲线特征及增重推荐范围探讨[J].中国妇幼保健,2007,22(31):4411-4415.
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[9]尹恒,黄莉,钟春蓉,等.孕前体质指数及孕期增重对巨大儿发生的影响[J].华中科技大学学报(医学版),2017,46(1):60-63.
[10]赵明,李光辉.妊娠中晚期增重速度与孕期总增重和新生儿出生体重的关系[J].北京医学,2015,37(7):629-632.
[2]许厚琴,杜莉,秦敏,等.上海市巨大儿影响因素及妊娠结局[J].中国妇幼保健,2010,25(9):1184-1188.
[3]于冬梅,翟凤英,赵丽云,等.中国2006年巨大儿发生率及其影响因素[J].中国儿童保健杂志,2008,16(1):11-13.
[4]陈芳芳,王文鹏,滕红红,等.1996至2010年北京市活产新生儿出生体重变化趋势及其影响因素[J].中国循证儿科杂志,2012,7(6):418-423.
[5]高竞,葛峰.巨大儿的分娩管理与肩难产的处理[J].国外医学.妇产科学分册,2001,28(4):245-246.
[6]李楠,张素杰.巨大儿发生情况及影响因素分析[J].中国医刊,2012,47(4):80-84.
[7]蒋一方,金焱,林钟芳,等.3种孕期增重曲线特征及增重推荐范围探讨[J].中国妇幼保健,2007,22(31):4411-4415.
[8]周敏,章小维,渠川琰,等.妊娠期适宜增重范围与出生体重的关系研究[J].中国实用妇科与产科杂志,2007,23(4):275-277.
[9]尹恒,黄莉,钟春蓉,等.孕前体质指数及孕期增重对巨大儿发生的影响[J].华中科技大学学报(医学版),2017,46(1):60-63.
[10]赵明,李光辉.妊娠中晚期增重速度与孕期总增重和新生儿出生体重的关系[J].北京医学,2015,37(7):629-632.