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目的探讨孕前超重、肥胖及孕期体重增加对妊娠结局的影响。方法用随机抽样的方法对715例孕前体质指数(BMI)正常、超重和肥胖单胎初产妇的临床资料进行回顾性分析。孕前BMI及美国医学会(IOM)2009年最新修订的孕期增重指南作为孕妇分组的标准。根据孕前BMI的不同分为正常BMI组(18.5≤BMI<25)和超重肥胖组(BMI≥25)。正常BMI组和超重肥胖组按照孕期增重是否合理再分为体重增长不足、体重增长正常和体重增长过多组并记录妊娠期糖尿病、妊娠期高血压、剖宫产、巨大儿、早产及低出生体重儿的发生率。结果孕妇孕前BMI为正常和超重肥胖者分别占75.2%、24.8%。正常BMI组与超重肥胖组孕妇妊娠期糖尿病分别占9.3%、22.0%,妊娠期高血压为4.1%、14.1%,剖宫产为36.6%、58.8%,早产为7.2%、13.6%,低出生体重儿为4.8%、9.6%。超重肥胖组孕妇的妊娠期糖尿病、妊娠期高血压、剖宫产、早产及低出生体重儿的发生率均高于正常BMI组(均P<0.05)。体重增长过多孕妇中正常BMI组孕妇和超重肥胖组孕妇妊娠期糖尿病分别为9.4%、22.4%,妊娠期高血压为5.1%、13.8%,剖宫产为41.4%、61.2%,早产为5.1%、12.5%。结论孕前超重肥胖或妊娠期体重过度增加可直接或间接地影响妊娠结局。
Objective To investigate the effect of overweight, obesity and weight gain during pregnancy on pregnancy outcomes. Methods The clinical data of 715 primiparous, overweight and obese single mothers with pre-congenital body mass index (BMI) were retrospectively analyzed by random sampling method. Pre-pregnancy BMI and the American Medical Association (IOM) 2009 revised guidelines for pregnancy weight gain as a group of pregnant women as the standard. According to pre-pregnancy BMI is divided into normal BMI group (18.5≤BMI <25) and overweight and obesity group (BMI≥25). Normal BMI group and overweight group according to the weight gain during pregnancy is reasonable and then divided into underweight, weight gain and weight gain too much group and record gestational diabetes, gestational hypertension, cesarean section, macrosomia, premature birth and low The incidence of birth weight children. Results The pre-pregnancy BMI was 75.2% and 24.8% respectively for normal and overweight and obesity. The gestational diabetes mellitus in normal BMI group and overweight and obesity group accounted for 9.3%, 22.0%, 4.1%, 14.1% respectively in gestational hypertension, 36.6%, 58.8% for cesarean section, 7.2% for preterm birth and 13.6% for low birth weight Weight children was 4.8%, 9.6%. The incidence of gestational diabetes mellitus, gestational hypertension, cesarean section, premature birth and low birth weight infants in overweight and obesity group were higher than those in normal BMI group (all P <0.05). Excessive body weight gain in pregnant women with normal BMI group and overweight and obesity group pregnant women with gestational diabetes meliorated 9.4%, 22.4% respectively, gestational hypertension was 5.1%, 13.8%, cesarean section was 41.4%, 61.2%, premature delivery was 5.1 %, 12.5%. Conclusion Overweight and obesity before pregnancy or pregnancy overweight may directly or indirectly affect pregnancy outcome.