中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2012年
9期
646-650
,共5页
人体质量指数%孕妇%体重增长%出生体重%妊娠结局
人體質量指數%孕婦%體重增長%齣生體重%妊娠結跼
인체질량지수%잉부%체중증장%출생체중%임신결국
Body mass index%Pregnant women%Weight gain%Birth weight%Pregnancy outcome
目的 探讨美国医学研究院( IOM) 2009年推荐的单胎妊娠妇女(单胎孕妇)孕期增重范围是否适合于中国孕妇.方法 回顾性分析2005年1至12月和2009年1至12月在北京大学第一医院分娩的糖代谢正常足月单胎孕妇4736例的临床资料,其中,2005年1964例,2009年2772例.根据孕前体质指数(BMI)分成3组:BMI＜ 18.5 kg/m2为低BMI组,465例；BMI 18.5 ～24.9 kg/m2为正常BMI组,3549例；BMI≥25.0 kg/m2为高BMI组,722例；3组根据孕期增重范围是否符合IOM推荐范围各分为低于推荐范围、符合推荐范围和高于推荐范围3种情况.分析孕妇年龄、分娩孕周、孕前体质量、孕前BMI、产次等有无差异,比较孕前不同BMI组孕妇孕期增重范围低于、高于IOM推荐范围者与符合推荐范围者母儿并发症有无差异.结果 (1)低BMI组孕期增重低于IOM推荐范围的孕妇分娩低出生体质量儿的风险较孕期增重符合推荐范围的孕妇有升高趋势(OR=3.71,95％ CI为0.97 ～ 14.12,P=0.055).(2)与正常BMI组孕期增重符合推荐范围的孕妇相比,同组内孕期增重高于推荐范围组孕妇分娩巨大儿的风险明显升高(OR =2.14,95％ CI为1.62～ 2.83,P＜0.01).(3)高BMI组孕期增重高于推荐范围的孕妇分娩巨大儿的风险较符合推荐范围孕妇升高(OR=3.25,95％ CI为1.65 ～6.39,P=0.001),发生妊娠期高血压疾病的风险升高(OR=1.79,95％ CI为1.04 ～3.09,P=0.037).结论 美国IOM 2009年推荐的足月单胎孕妇孕期增重范围比较适合于中国孕妇.
目的 探討美國醫學研究院( IOM) 2009年推薦的單胎妊娠婦女(單胎孕婦)孕期增重範圍是否適閤于中國孕婦.方法 迴顧性分析2005年1至12月和2009年1至12月在北京大學第一醫院分娩的糖代謝正常足月單胎孕婦4736例的臨床資料,其中,2005年1964例,2009年2772例.根據孕前體質指數(BMI)分成3組:BMI＜ 18.5 kg/m2為低BMI組,465例；BMI 18.5 ～24.9 kg/m2為正常BMI組,3549例；BMI≥25.0 kg/m2為高BMI組,722例；3組根據孕期增重範圍是否符閤IOM推薦範圍各分為低于推薦範圍、符閤推薦範圍和高于推薦範圍3種情況.分析孕婦年齡、分娩孕週、孕前體質量、孕前BMI、產次等有無差異,比較孕前不同BMI組孕婦孕期增重範圍低于、高于IOM推薦範圍者與符閤推薦範圍者母兒併髮癥有無差異.結果 (1)低BMI組孕期增重低于IOM推薦範圍的孕婦分娩低齣生體質量兒的風險較孕期增重符閤推薦範圍的孕婦有升高趨勢(OR=3.71,95％ CI為0.97 ～ 14.12,P=0.055).(2)與正常BMI組孕期增重符閤推薦範圍的孕婦相比,同組內孕期增重高于推薦範圍組孕婦分娩巨大兒的風險明顯升高(OR =2.14,95％ CI為1.62～ 2.83,P＜0.01).(3)高BMI組孕期增重高于推薦範圍的孕婦分娩巨大兒的風險較符閤推薦範圍孕婦升高(OR=3.25,95％ CI為1.65 ～6.39,P=0.001),髮生妊娠期高血壓疾病的風險升高(OR=1.79,95％ CI為1.04 ～3.09,P=0.037).結論 美國IOM 2009年推薦的足月單胎孕婦孕期增重範圍比較適閤于中國孕婦.
목적 탐토미국의학연구원( IOM) 2009년추천적단태임신부녀(단태잉부)잉기증중범위시부괄합우중국잉부.방법 회고성분석2005년1지12월화2009년1지12월재북경대학제일의원분면적당대사정상족월단태잉부4736례적림상자료,기중,2005년1964례,2009년2772례.근거잉전체질지수(BMI)분성3조:BMI＜ 18.5 kg/m2위저BMI조,465례；BMI 18.5 ～24.9 kg/m2위정상BMI조,3549례；BMI≥25.0 kg/m2위고BMI조,722례；3조근거잉기증중범위시부부합IOM추천범위각분위저우추천범위、부합추천범위화고우추천범위3충정황.분석잉부년령、분면잉주、잉전체질량、잉전BMI、산차등유무차이,비교잉전불동BMI조잉부잉기증중범위저우、고우IOM추천범위자여부합추천범위자모인병발증유무차이.결과 (1)저BMI조잉기증중저우IOM추천범위적잉부분면저출생체질량인적풍험교잉기증중부합추천범위적잉부유승고추세(OR=3.71,95％ CI위0.97 ～ 14.12,P=0.055).(2)여정상BMI조잉기증중부합추천범위적잉부상비,동조내잉기증중고우추천범위조잉부분면거대인적풍험명현승고(OR =2.14,95％ CI위1.62～ 2.83,P＜0.01).(3)고BMI조잉기증중고우추천범위적잉부분면거대인적풍험교부합추천범위잉부승고(OR=3.25,95％ CI위1.65 ～6.39,P=0.001),발생임신기고혈압질병적풍험승고(OR=1.79,95％ CI위1.04 ～3.09,P=0.037).결론 미국IOM 2009년추천적족월단태잉부잉기증중범위비교괄합우중국잉부.
Objective To study whether the current Institute of Medicine (IOM) pregnancy weight gain recommendations vary by pre-pregnancy body mass index (BMI) was suitable to Chinese people.Methods A study was conducted on 4736 term singleton live birth gravidas,who were diagnosed normal glucose metabolism and delivered in Peking University First Hospital in 2005 and 2009,by reviewing the medical records.Based on the pre-pregnant BMI,the selected cases were divided into 3 groups:low body mass group ( BMI ＜ 18.5 kg/m2,n =465 ),normal body mass group ( BMI 18.5 - 24.9 kg/m2,n =3549),over body mass group ( BMI ≥ 25 kg/m2,n =722).All the cases were divided into 3 subgroups based on pregnancy weight gain as below,within,and above the IOM recommendations in each pre-pregnant BMI group.Totally 4736 newborns were divided by birth weight into 3 groups:normal birth weight group ( weight 2500 - 4000 g,n =4339 ),macrosomia group ( weight ≥ 4000 g,n =359 ) and low birth weight group (weight ＜ 2500 g,n =38).The difference of age,gestational age,pre-pregnant weight,pre-pregnant BMI and history of delivery of cases between 2005 and 2009 were analyzed.The difference of pregnancy outcome of women whose gestational weight gain was below,within,and above the IOM recommendations was analyzed.Results (1) Compared to mothers with pregnancy weight gain within IOM recommendations in low body mass group,risk of low birth weight in offspring was elevated tendency with pregnancy weight gain below IOM recommendations ( OR =3.71,95％ CI:0.97 - 14.12,P =0.055 ).(2) In normal body mass group, compared to women with pregnancy weight gain within IOM recommendations, risk of macrosomia in offspring was elevated with pregnancy weight gain above IOM recommendations ( OR =2.14,95％ CI:1.62 - 2.83,P ＜ 0.01 ).( 3 ) In over body mass group,compared to women with pregnancy weight gain within IOM recommendations,risk of macrosomia in offspring was elevated ( OR =3.25,95％ CI:1.65 -6.39,P =0.001 ) and risk of hypertensive disorders complicating pregnancy was high ( OR =1.79,95％ CI:1.04 -3.09,P =0.037 ) in women with pregnancy weight gain above IOM recommendations.Conclusion The current IOM pregnancy weight gain recommendations vary by pre-pregnancy BMI may be suitable to Chinese people.
