發(fā)布時間：2018-01-22 01:11

  本文關(guān)鍵詞： 孕期增重 新生兒體重 基本情況 鍛煉習(xí)慣 被動吸煙 孕前BMI　出處：《河北醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:描述河北省孕婦的一般情況和生活方式的現(xiàn)狀,分析影響孕期體重增加和新生兒出生體重的關(guān)鍵因素,進一步探討孕期體重增加與新生兒出生體重的關(guān)聯(lián)。方法:選取2013年3月—2014年5月,經(jīng)知情同意,納入孕6-12周內(nèi)在所指定社區(qū)衛(wèi)生服務(wù)中心或醫(yī)院產(chǎn)科門診建本并擬定期來檢查和分娩的早孕婦女共586例,對調(diào)查者進行孕婦生活方式與母嬰健康調(diào)查項目,建立健康檔案并對各項健康指標(biāo)進行追蹤觀察。調(diào)查指標(biāo)包括孕前身高和體重,孕6-12周、孕28周、孕36周及分娩前、后的體重及產(chǎn)后附屬物的重量,孕婦24小時膳食回顧調(diào)查和體力活動調(diào)查,以及妊娠結(jié)局、新生兒出生體重、出生身長、出生頭圍等。建立EPIDATA數(shù)據(jù)庫,雙人錄入,采用SPSS13.0和SAS9.3軟件進行統(tǒng)計分析。計量資料以“均數(shù)±標(biāo)準(zhǔn)差”表示,計數(shù)資料以構(gòu)成比表示,兩樣本均數(shù)比較采用t檢驗,多組計量資料比較采用單因素方差分析,計數(shù)資料的分析采用卡方檢驗,與不同孕期體重增加的影響因素采用多分類有序logistic回歸分析,和新生兒出生體重相關(guān)的影響因素采用多元線性回歸分析,顯著性檢驗水準(zhǔn)均取雙側(cè)α=0.05。結(jié)果:石家莊9所社區(qū)衛(wèi)生服務(wù)中心及衡水2所醫(yī)院共計586例孕婦納入此次調(diào)查,并分娩單胎活產(chǎn)兒。排除失訪(n=33)、流產(chǎn)(n=21)、引產(chǎn)(n=4)、胎停育(n=3)后,共計525名分娩單胎活產(chǎn)兒的孕婦進入數(shù)據(jù)統(tǒng)計分析。剖宮產(chǎn)(n=229)、自然分娩(n=296),經(jīng)產(chǎn)婦(n=76)、初產(chǎn)婦(n=449)。孕前平均體質(zhì)指數(shù)(21.21士3.02)kg/m2,孕期體重平均增加(15.80士3.55)kg,高于推薦的12.5kg,新生兒平均出生體重(3400.5±427.92)g,大多集中在正常范圍內(nèi)。孕期體重增加分為三組:孕期體重增加不足組(n=46),占8.76%;孕期體重增加正常組(n=239),占45.52%;孕期體重增加過度組(n=240),占45.71%。不同孕期體重增加情況與孕婦年齡、孕前BMI、孕期是否鍛煉、孕中、晚期是否被動吸煙、新生兒體重具有相關(guān)性(P0.05)。孕期體重增加不足組和過度組的BMI均大于正常組;31-35歲平均孕前體質(zhì)指數(shù)最高(22.0±2.9)kg/m2;妊娠期體重增加隨著年齡增加而降低;孕婦在孕期不鍛煉者比鍛煉者孕期體重增加較高;孕婦在孕中、晚期被動吸煙者孕期體重增加較高;母親孕期體重增長越多,新生兒出生體重越大。孕期體重增加情況與胎盤重量、生產(chǎn)次數(shù)等不存在顯著相關(guān),差異無統(tǒng)計學(xué)意義(P0.05)。新生兒出生體重與孕早期是否鍛煉、丈夫孕前一個月是否吸煙、孕中、晚期是否被動吸煙、孕婦家是否有高血壓、胎盤重量之間具有相關(guān)性(P0.05)。孕早期無鍛煉者,新生兒出生體重高于孕早期有鍛煉的孕婦;丈夫孕前一個月吸煙的,孕中、晚期被動吸煙者,新生兒體重較高;胎盤重量大的孕婦分娩的新生兒體重高于胎盤重量低的孕婦;孕婦家有高血壓的,新生兒體重較低。新生兒出生體重與孕婦年齡、孕前體質(zhì)指數(shù)BMI等不存在顯著相關(guān),差異無統(tǒng)計學(xué)意義(P0.05)。不同孕期體重增加情況的多因素有序logistic回歸分析顯示,孕婦年齡、孕前體質(zhì)指數(shù)BMI、孕中期是否經(jīng)常鍛煉和新生兒體重是孕期體重增加的獨立影響因素,孕婦年齡和孕期體重增加存在顯著的負(fù)相關(guān)。新生兒出生體重的多元線性回歸分析顯示,胎盤重量、孕晚期被動吸煙、孕早期沒有鍛煉習(xí)慣和孕婦家有高血壓是新生兒體重的獨立危險因素。孕早、中、晚三期能量和產(chǎn)能營養(yǎng)素(蛋白質(zhì)、脂肪和碳水化合物)的攝入情況較為理想,隨孕周增加,能量和產(chǎn)能營養(yǎng)素攝入均在增加,且能量攝入數(shù)據(jù)在合理范圍內(nèi)。結(jié)論:孕婦年齡、孕前BMI、孕期是否鍛煉、孕期是否被動吸煙、新生兒出生體重是不同孕期體重增加的影響因素。孕期是否鍛煉、孕期是否被動吸煙、丈夫是否在孕前吸煙、胎盤重量是新生兒出生體重的影響因素。孕期營養(yǎng)攝入較為合理。
[Abstract]:Objective: to describe the status of pregnant women in Hebei province of the general situation and the way of life, analysis the influence factors of weight gain during pregnancy and neonatal birth weight, gestational weight gain and to further explore the association of neonatal birth weight. Methods: from March 2013 to May 2014, after informed consent, included in the 6-12 weeks of gestation within designated community health service center or hospital the construction of gynecology clinic and intends to check regularly and delivered a total of 586 cases of pregnant women, pregnant women and maternal and child health lifestyle survey project of the survey, the establishment of health records and follow-up observation of the health indicators. Survey indicators including prepregnancy weight and height, gestational age of 6-12 weeks, at 28 weeks, 36 weeks of pregnancy and childbirth before, after the weight and the weight of pregnant women postpartum appendages, 24 hour dietary survey and physical activity survey, and the outcome of pregnancy, birth weight, birth Length, head circumference and so on. The establishment of EPIDATA database, double entry, statistical analysis was performed using SPSS13.0 and SAS9.3 software. Measurement data were expressed as the "standard deviation", count data to the constituent ratio, two samples were compared using t test, multiple sets of measurement data were compared with single factor analysis of variance, analysis. The data were analyzed by chi square test, and the influencing factors of different pregnancy weight regression analysis using polytomous logistic, and neonatal birth weight related factors using multiple linear regression analysis, significant test level was taken from bilateral alpha =0.05. results: the survey a total of 586 cases of pregnant women in the 2 Shijiazhuang 9 community health service center and the Hengshui hospital, and delivered single live births. Excluding missing (n=33), (n=21), induced abortion (n=4), stop child education (n=3), a total of 525 pregnant women who delivered singleton live births into data Statistical analysis of cesarean section (n=229), natural childbirth (n=296), (n=76), multipara primipara pregnancy (n=449). The average body mass index (21.21 + 3.02) kg/m2, pregnancy weight increased by an average of (15.80 + 3.55) kg, higher than that recommended by 12.5kg, the average birth weight (3400.5 + 427.92) g, mostly concentrated in the normal range. The weight increase during pregnancy were divided into three groups: gestational weight gain (n=46), insufficient group accounted for 8.76%; pregnancy weight gain in normal group (n=239), accounting for 45.52%; excessive weight gain during pregnancy group (n=240), accounting for 45.71%. of different weight gain during pregnancy and maternal age, pre pregnancy BMI pregnancy exercise, pregnancy, whether passive smoking is associated with neonatal birth weight, gestational weight gain (P0.05). Lack of group and over group BMI were higher than that in normal group; 31-35 years average pregnancy body mass index highest (22 + 2.9) kg/m2; gestational weight gain decreased with age; pregnant women Do not exercise during pregnancy increased higher than exercise weight during pregnancy; pregnant women during pregnancy and late pregnancy weight gain higher passive smokers; maternal weight gain more and more. The birth weight of newborns weight gain during pregnancy and placental weight, production times are not significantly related to the difference was not statistically significant (P0.05). Birth body weight and early pregnancy is a month before exercise, husband smoking, pregnancy, late pregnant women whether passive smoking, not associated with hypertension, placental weight between early pregnancy (P0.05). No exercise, weight is higher than the early pregnancy exercise pregnant women birth; her husband before one month smoking, pregnancy in the late stage, passive smoking, high birth weight childbirth; birth weight placental weight is higher than that of large placental weight low pregnant women; pregnant women with hypertension, neonatal weight Low neonatal birth weight and maternal age, pre pregnancy body mass index was not significantly related to BMI, the difference was not statistically significant (P0.05). Multivariate ordinal logistic different maternal weight gain of the regression analysis showed that maternal age, pre pregnancy body mass index BMI, the second trimester whether regular exercise and weight of newborns were independent factors of pregnancy weight the increase of maternal age and gestational weight gain was significantly negative correlation. Multiple linear regression analysis showed that the neonatal birth weight, placental weight, late pregnancy in early pregnancy without passive smoking, exercise habits and pregnant women with hypertension were independent risk factors of neonatal weight. In early pregnancy, late in the three period, energy and capacity of nutrition peptide (protein, fat and carbohydrate intake) is ideal, with the increase of gestational age, energy and nutrient intake capacity increased, and energy intake data In a reasonable range. Conclusion: maternal age, pre pregnancy BMI, pregnancy exercise during pregnancy, whether passive smoking, neonatal birth weight is different influencing factors of pregnancy weight gain during pregnancy. Whether exercise, whether passive smoking during pregnancy, whether the husband before smoking, placental weight infant birth weight is affected by maternal nutrition intake is more. Reasonable.

【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R715.3

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本文編號：1453148