摘要/Abstract
摘要： 目的 ·了解上海市松江区妇女孕期增重（gestational weight gain，GWG）情况，探讨 GWG与妊娠结局之间的关系。方法 ·共收集 2016年 7月— 12月在上海市松江区妇幼保健院产检并住院分娩的妇女 4 884例，根据 2009年美国医学研究所（Institute of Medicine， IOM）制定的 GWG范围分为 GWG过少组、 GWG正常组和 GWG过多组，分析 GWG对新生儿出生体质量、孕龄、新生儿评分以及不良妊娠结局如早产、小于胎龄儿（ small-for-gestational age，SGA）、大于胎龄儿（ large-for-gestational age，LGA）、巨大儿的影响。结果 · GWG过少者占 25.7%，GWG过多者占 33.3%。新生儿出生体质量随着 GWG的增加而增加（β24.17，95% CI为 21.90～ 26.45， P0.000）；GWG对于发生 SGA是保护因素（ OR0.89，95% CI为 0.87～ 0.91，P0.000），对于发生 LGA（OR1.12，95% CI为 1.09～ 1.14，P0.000）及巨大儿（ OR1.14，95% CI为 1.11～ 1.16，P0.000）是危险因素。孕龄随着 GWG增加而延长（ β0.03， 95% CI为 0.03～ 0.04，P0.000）；GWG是早产发生的保护因素（ OR0.91，95% CI为 0.88～ 0.95，P0.000）。相对于 GWG正常组， GWG过少组更易发生 SGA（OR1.54，95% CI为 1.22～ 1.94，P0.000）和早产（OR1.53，95% CI为 1.03～ 2.26，P0.034），GWG过多组则更易于发生 LGA（OR2.20，95% CI为 1.71～ 2.84，P0.000）和巨大儿（ OR2.41，95% CI为 1.86～ 3.11，P0.000）。结论 ·孕期保持适宜的体质量增加对改善妊娠结局有重要意义，需重视对孕产期体质量的管理，保障母婴健康。
关键词: 孕期增重, 出生体质量, 孕龄, 早产
Abstract:
Objective · To understand the status of gestational weight gain (GWG) during pregnancy among women in Songjiang District, Shanghai, and to explore the relationship between GWG and birth outcomes. Methods · 4 884 cases were collected in Maternal and Child Health Hospital of Songjiang District, Shanghai July to December 2016. According to the range of GWG formulatedthe Institute of Medicine (IOM) in 2009, the subjects were divided into the insufficient GWG group, the normal GWG group, and the excessive GWG group. The relationship between GWG and the birth outcome of the newborn, mainly including the neonatal weight, the birth gestational week, the neonatal score, and the bad birth outcome such as premature delivery, small-for-gestational age (SGA), large-for-gestational age (LGA), and macrosomia were analyzed. Results · 25.7% of pregnant women gained underweight during pregnancy. 33.3% of pregnant women gained overweight during pregnancy. The GWG was positively correlated with birth weight (β24.17, 95% CI 21.90-26.45, P0.000). GWG was a protective factor for SGA (OR0.89, 95% CI 0.87-0.91, P0.000). GWG was a risk factor for LGA (OR1.12, 95% CI 1.09-1.14, P0.000) and macrosomia (OR1.14, 95% CI 1.11-1.16, P0.000). The GWG was positively associated with gestational age (β0.03, 95% CI 0.03-0.04, P0.000). The incidence of the premature delivery decreased with the increasing of GWG (OR0.91, 95% CI 0.88-0.95, P0.000). Women with insufficient GWG exhibited increased risks of SGA infants (OR1.54, 95% CI 1.22-1.94, P0.000) and premature delivery (OR1.53, 95% CI 1.03-2.26, P0.034), whereas women with excessive GWG exhibited increased risk of LGA (OR2.20, 95% CI 1.71-2.84, P0.000) and macrosomia (OR2.41, 95% CI 1.86-3.11, P0.000), when compared with women who had normal GWG. Conclusion · It is of great significance to maintain proper GWG and to improve the outcome of birth. Attention should be paid to the management of weight during pregnancy.
Key words: gestational weight gain, birth weight, gestational age, premature delivery
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