CAJ | 학술논문

目的：探讨孕前体重和孕期增重对妊娠结局的影响。方法采用前瞻性队列研究和整群抽样，对福建省妇幼保健院围产营养门诊既往无高血压、糖尿病、血脂异常等病史，且本次妊娠未发现心脏、肝脏、肾脏、甲状腺等器官疾病的单胎妊娠孕妇进行问卷调查，追踪其围产过程并发症、分娩方式及新生儿出生结局等。采用相关分析、χ2检验和logistic回归分析孕前体重、孕期增重与妊娠结局的关系。结果623名孕妇纳入分析592名（95%）。多因素logistic回归分析显示，在控制相关混杂因素后，相比孕前适宜体重孕妇（BMI 18.5～24.0 kg/m2），孕前低体重（BMI＜18.5 kg/m2）是低出生重量指数（PI）的危险因素（OR＝2.34，95%CI：1.24～4.42），孕前超重（BMI＞24.0 kg/m2）是高出生PI的危险因素（OR＝2.73，95%CI：1.12～6.68）。相比孕期增重适宜（孕期增重P15～P85）、增重不足（孕期增重＜P15）的孕妇，发生早产、低出生体重儿、妊娠糖尿病和低出生PI的OR值（95%CI）分别为4.85（1.35～17.51）、10.30（2.29～46.35）、2.29（1.07～4.93）和2.65（1.24～5.68）；孕期增重过多孕妇（孕期增重＞P85）生产巨大儿、高出生PI和妊娠糖尿病的OR值（95%CI）分别为3.83（1.74～8.44）、2.39（1.14～5.01）和2.21（1.07～4.55）。结论孕前低体重和超重均影响新生儿出生PI。孕期增重不足是早产、低出生体重儿、妊娠糖尿病和低出生PI的危险因素，孕期增重过多是高出生PI和妊娠糖尿病的危险因素。
목적：탐토잉전체중화잉기증중대임신결국적영향。방법채용전첨성대렬연구화정군추양，대복건성부유보건원위산영양문진기왕무고혈압、당뇨병、혈지이상등병사，차본차임신미발현심장、간장、신장、갑상선등기관질병적단태임신잉부진행문권조사，추종기위산과정병발증、분면방식급신생인출생결국등。채용상관분석、χ2검험화logistic회귀분석잉전체중、잉기증중여임신결국적관계。결과623명잉부납입분석592명（95%）。다인소logistic회귀분석현시，재공제상관혼잡인소후，상비잉전괄의체중잉부（BMI 18.5～24.0 kg/m2），잉전저체중（BMI＜18.5 kg/m2）시저출생중량지수（PI）적위험인소（OR＝2.34，95%CI：1.24～4.42），잉전초중（BMI＞24.0 kg/m2）시고출생PI적위험인소（OR＝2.73，95%CI：1.12～6.68）。상비잉기증중괄의（잉기증중P15～P85）、증중불족（잉기증중＜P15）적잉부，발생조산、저출생체중인、임신당뇨병화저출생PI적OR치（95%CI）분별위4.85（1.35～17.51）、10.30（2.29～46.35）、2.29（1.07～4.93）화2.65（1.24～5.68）；잉기증중과다잉부（잉기증중＞P85）생산거대인、고출생PI화임신당뇨병적OR치（95%CI）분별위3.83（1.74～8.44）、2.39（1.14～5.01）화2.21（1.07～4.55）。결론잉전저체중화초중균영향신생인출생PI。잉기증중불족시조산、저출생체중인、임신당뇨병화저출생PI적위험인소，잉기증중과다시고출생PI화임신당뇨병적위험인소。
Objective To study the impacts of pre-pregnancy maternal BMI and gestational weight gain(GWG)on pregnancy outcomes. Methods We adopted a prospective cohort study with cluster sampling in single pregnant women,who were not with hypertension,diabetes,hyperlipidemia or other diseases in the previous history,neither did they have diseases of heart,liver,kidney,thyroid etc. related to current pregnancy. Those pregnant women who visited the prenatal nutrition clinic under‘informed consent’were surveyed with questionnaire to track their peri-natal complications,delivery mode and neonate birth outcomes etc. Pearson and partial correlations,chi-square test and binary logistic regression were used to study the association between pre-pregnancy maternal BMI,GWG and pregnancy outcomes. Results A total of 623 pregnant women were recruited in the cohort,with 592(95%)of them eligible for analysis. Results from the Multivariate Logistic Regression analysis indicated that,after controlling the potential confounding factors,when compared to women with pre-pregnancy BMI between 18.5 and 24.0,the odds ratios(ORs)for low birth ponderal index(PI) were 2.34[95%confidence interval(CI),1.24-4.42)]among those with BMI<18.5,respectively,while 2.73(1.12-6.68)for high birth PI among those with BMI>24.0. Similarly,when compared to pregnant women with normal GWG(defined as weight gain range from P15 to P85 by stratification of pre-pregnancy BMI),low GWG(<P15)seemed to be the risk factor for preterm birth,low birth weight,gestational diabetes mellitus,with low birth PI [ORs as 4.85(1.35-17.51),10.30 (2.29-46.35),2.29(1.07-4.93) and 2.65(1.24-5.68),respectively. High GWG(>P85)appeared the risk factor for high birth weight,high birth PI,and gestational diabetes mellitus,with ORs as 3.83(1.74-8.44),2.39(1.14-5.01) and 2.21(1.07-4.55),respectively. Conclusion Low or high pre-pregnancy maternal BMI and GWG were associated with adverse pregnancy outcomes.