本文選題：雙胎妊娠　切入點：體質(zhì)量　出處：《實用婦產(chǎn)科雜志》2017年05期

【摘要】：目的:分析雙胎妊娠孕期不同階段體質(zhì)量增長情況與母嬰結(jié)局的關系。方法:對2013年1月至2015年10月在上海交通大學醫(yī)學院附屬國際和平婦幼保健院住院分娩的472例雙胎妊娠產(chǎn)婦的臨床資料進行回顧性分析,比較不同孕前BMI孕婦孕期體質(zhì)量增長情況,在校正年齡和孕前BMI后,使用二元Logistic回歸分析孕期不同階段體質(zhì)量增長速度與孕期并發(fā)癥、早產(chǎn)、胎膜早破和新生兒出生體質(zhì)量的關系。結(jié)果:(1)孕早中期平均體質(zhì)量增長速度0.41±0.15 kg/w,孕晚期平均體質(zhì)量增長速度0.64±0.30 kg/w,整個孕期平均體質(zhì)量增長速度0.49±0.15 kg/w。(2)孕晚期和整個孕期體質(zhì)量增長過快是妊娠期高血壓疾病和發(fā)生早產(chǎn)的高危因素(P0.05),孕早中期、孕晚期及整個孕期體質(zhì)量增長過快是發(fā)生胎膜早破的高危因素(P0.05),孕早中期及整個孕期的體質(zhì)量增長過慢是新生兒低出生體質(zhì)量的高危因素(P0.05)。(3)在校正年齡、孕前BMI、孕周等因素后,孕期體質(zhì)量每增加1 kg,雙胎出生體質(zhì)量之和增加25.21 g(P0.001);孕早中期每增加1 kg,雙胎出生體質(zhì)量之和增加30.89 g(P0.001);孕晚期每增加1 kg,雙胎出生體質(zhì)量之和增加21.46 g(P=0.001)。結(jié)論:雙胎妊娠孕期體質(zhì)量增長與母嬰不良結(jié)局密切相關,妊娠不同階段的體質(zhì)量增長速度對母嬰結(jié)局有一定的預測價值,應進一步探討適合中國人群的雙胎妊娠孕期體質(zhì)量增長適宜范圍。
[Abstract]:Objective: to analyze the relationship between the growth of body mass and the outcome of pregnancy in twin pregnancy.Methods: from January 2013 to October 2015, the clinical data of 472 pregnant women with twin pregnancy who were delivered in the International Peace Maternal and Child Health Hospital of Shanghai Jiaotong University from January 2013 to October 2015 were analyzed retrospectively.To compare the growth of body mass in pregnant women with BMI before pregnancy, after adjusting age and BMI before pregnancy, binary Logistic regression analysis was used to analyze the growth rate of body mass in different stages of pregnancy and complications during pregnancy, preterm delivery.Relationship between premature rupture of membranes and birth weight of newborns.Results the average body mass growth rate in the first trimester of pregnancy was 0.41 鹵0.15 kg / w, in the third trimester was 0.64 鹵0.30 kg / w, and in the whole pregnancy was 0.49 鹵0.15 kg / w.m-2) the rapid growth of body mass in the third trimester and the whole pregnancy was the cause of hypertension complicating pregnancy.The high risk factors of disease and preterm delivery were P0.05, and the second trimester of pregnancy.The high risk factors of premature rupture of membranes were the rapid growth of body mass in the third trimester of pregnancy and the whole pregnancy. The slow growth of body mass in the second trimester and the whole pregnancy was the high risk factor of low birth weight of the newborn (P0.05. 3) after adjusting for age, BMIbefore pregnancy, gestational age, etc.The sum of body mass of twins increased by 25.21 g / P0.001 for each increase of 1 kg in pregnancy, 30.89 g / g P0.001 / kg for each increase of 1 kg in the first trimester of pregnancy, and 21.46 g / kg for the second trimester of pregnancy, and 21.46 g / kg for the second trimester of pregnancy.Conclusion: the growth of body mass in twin pregnancy is closely related to the adverse outcome of mother and child. The growth rate of body mass in different stages of pregnancy has certain value in predicting the outcome of mother and child.It is necessary to further explore the suitable range of body mass growth in twin pregnancy for Chinese population.
【作者單位】： 上海交通大學醫(yī)學院附屬國際和平婦幼保健院;
【基金】：上海市教委護理高原學科項目(編號:Hlgy15007yjx)
【分類號】：R714.23

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