本文選題：孕前體重指數(shù) + 孕期增重��； 參考：《現(xiàn)代婦產(chǎn)科進(jìn)展》2017年05期

【摘要】：目的:探討正常足月孕婦孕期不同階段增重與新生兒出生體重的關(guān)系。方法:回顧分析2014年1月至2014年12月在嵊州人民醫(yī)院定期產(chǎn)前檢查并且正常足月單胎孕婦2634例的臨床資料。根據(jù)孕前體重指數(shù)(BMI)分為3組:低體重組(18.5kg/m2),正常體重組(18.5~23.9kg/m2),超重組(24~27.9kg/m2)。收集孕婦早、中、晚孕期的體重增加值,分析孕期不同階段增重與新生兒出生體重的關(guān)系。結(jié)果:低體重組、正常體重組和超重組孕期增重分別為15.0kg(12.7,17.7kg)、14.5kg(12.0,17.5kg)和13.0kg(9.0,16.0kg);新生兒出生體重分別為3230g(3000,3470g)、3330g(3090,3600g)和3437g(3140,3722g),3組比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。低體重組、正常體重組和超重組早孕期增重分別為1.4kg(0.6,2.3kg)、1.1kg(0.6,2.1kg)和1.1kg(0.4,1.9kg);中孕期增重分別為7.8kg(6.5,9.4)kg、7.5kg(6.0,9.0kg)和6.5kg(4.8,8.1kg);晚孕期增重分別為5.8kg(4.2,7.5kg)、5.7kg(4.2,7.4kg)和5.1kg(3.5,7.0kg);同孕期3組比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)�；貧w結(jié)果表明,除低體重組晚孕期和超重組早孕期以外,其余各孕期體重增加對新生兒出生體重均有促進(jìn)作用。其中低體重組早孕期增重對新生兒體重增加影響最大(標(biāo)準(zhǔn)化回歸系數(shù)0.21,P0.05);正常體重組和超重組中孕期增重對新生兒體重增加影響最大(標(biāo)準(zhǔn)化回歸系數(shù)分別為0.18,0.10,P均0.05)。含啞變量的回歸結(jié)果示,對整個研究群體而言,中孕期增重對出生體重的影響最大(標(biāo)準(zhǔn)化回歸系數(shù)0.18,P0.05);相對于正常體重組早孕期增重對新生兒出生體重增加的影響而言,低體重組孕早期增重影響更大(標(biāo)準(zhǔn)化回歸系數(shù)差為0.05,P0.05),而超重組最小(標(biāo)準(zhǔn)化回歸系數(shù)差為-0.06,P0.05)。結(jié)論:孕前BMI和孕期不同階段增重與新生兒出生體重有關(guān);低體重組早孕期增重對新生兒出生體重增加影響最明顯,而正常體重組和超重組則中孕期增重對新生兒體重增加最明顯。因此,根據(jù)孕前BMI制定孕期不同階段合理增重對于控制新生兒體重具有指導(dǎo)意義。
[Abstract]:Objective: to investigate the relationship between birth weight gain and birth weight of normal term pregnant women at different stages of pregnancy. Methods: the clinical data of 2634 pregnant women with normal term single pregnancy from January 2014 to December 2014 in Shengzhou people's Hospital were retrospectively analyzed. BMIs were divided into three groups: low weight group (18.5kg / m2), normal weight group (18.5kg / m2), hyperrecombination group (2427.9 kg / m2). To collect the weight gain of pregnant women in early, middle and late pregnancy, and to analyze the relationship between birth weight and birth weight in different stages of pregnancy. Results: in low body weight group, normal body weight group and super reconstituted pregnancy weight gain group were 15.0 kg / kg 12.7kg / 17.7 kg / kg and 13.0kg / 9.0kg / kg respectively, and the birth weight of newborns were 3230g / 3000g / 3470g / kg ~ 3330g / 30903600g) and 3437g / 3140g / 3722g / g respectively. In the low body weight group, the weight gain in the normal body weight group and the superrecombinant early pregnancy group were 1.4 kg 路kg ~ (0.6) and 2.3kg ~ (2. 3) kg ~ (-1) 路kg ~ (-1)? The results of regression analysis showed that, except for the late pregnancy and the superrecombinant early pregnancy in the low weight group, the weight gain during the other pregnancy had a positive effect on the birth weight of the newborn. In the low weight group, the weight gain in early pregnancy had the greatest effect on the newborn weight gain (standardized regression coefficient was 0.21%, P 0.05), and the weight gain in normal weight group and over recombination group had the greatest effect on the newborn weight gain (the standardized regression coefficient was 0.18 ~ 0.10) (P < 0.05). Regression results with dummy variables showed that weight gain during pregnancy had the greatest effect on birth weight for the whole study population (standardized regression coefficient 0.18, P 0.05), compared with the effect of weight gain during early pregnancy on birth weight gain in normal weight group. In low body weight group, the effect of weight gain was greater (the difference of standardized regression coefficient was 0.05p 0.05, and the difference of standard regression coefficient was -0.06g P 0.05). Conclusion: BMI before pregnancy and weight gain at different stages of pregnancy are related to the birth weight of the newborn, and the weight gain in the early pregnancy of low weight group has the most obvious effect on the birth weight gain of the newborn. In normal weight group and hyperrecombination group, weight gain during pregnancy was the most significant in newborns. Therefore, reasonable weight gain in different stages of pregnancy according to BMI before pregnancy is of guiding significance for the control of neonatal weight.
【作者單位】： 浙江大學(xué)醫(yī)學(xué)院附屬婦產(chǎn)科醫(yī)院;嵊州市人民醫(yī)院;
【基金】：浙江省衛(wèi)計(jì)委科研項(xiàng)目和省部共建項(xiàng)目資助(No:2014KYA248和WKJ-ZJ-1722) 國家自然科學(xué)基金資助(No:81370725)
【分類號】：R714

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