【摘要】：目的分析孕婦懷孕前的不同體重以及在懷孕期間體重的增長變化與妊娠結(jié)局以及產(chǎn)科常見并發(fā)癥的相關(guān)性,探討孕期體重以及適當(dāng)?shù)脑衅谠鲋胤秶?指導(dǎo)孕期保健,制定合理的個(gè)體化體重管理,從而極大的降低分娩過程中和妊娠晚期并發(fā)癥發(fā)生的概率. 方法對在臨沂市婦幼保健院(三級甲等婦幼保健院醫(yī)院)進(jìn)行產(chǎn)前檢查到在本院住院分娩的符合條件的孕婦進(jìn)行前瞻性檢查,采用標(biāo)準(zhǔn)的操作規(guī)程準(zhǔn)確測量,所測量的孕婦身高及體重均為脫鞋測量,記錄孕婦的身高、記錄孕婦孕前一個(gè)月的體重、產(chǎn)前體重(分娩時(shí)的孕婦體重)、妊娠期并發(fā)癥(妊娠期高血壓疾病及妊娠期糖尿病)的發(fā)生情況、最終的分娩方式、新生兒的出生體重及阿氏評分、巨大兒以及圍產(chǎn)兒的并發(fā)癥情況,搜集整理資料,繪制孕期增重圖,計(jì)算孕婦孕前體重指數(shù)(BMI)即孕前體重?cái)?shù)(kg)/身高(m)2,孕期增重的數(shù)值為產(chǎn)前體重與孕前體重的差值。根照所計(jì)算的孕婦孕前體重指數(shù)將孕婦分為四組：肥胖組(BMI≥25)、超重組(23≤BMI25)、正常組(18.5≤BMI23)、消瘦組(BMI＜18.5)；根據(jù)孕婦在孕期體重增加的數(shù)值(△W)情況將孕婦分為三組：△W15kg、15kg≤△W20kg、△W≥20kg。據(jù)此分析和比較各組孕婦間妊娠結(jié)局以及并發(fā)癥的發(fā)生情況。利用SPS17.0統(tǒng)計(jì)學(xué)軟件進(jìn)行分析。 結(jié)果 1)比較孕前體重各組孕婦發(fā)生產(chǎn)程阻滯難產(chǎn)、剖宮產(chǎn)的概率,差異顯著,具有統(tǒng)計(jì)學(xué)意義(P＜0.05)。 2)對孕前體重各組孕婦妊娠期糖尿病、妊娠期高血壓疾病及巨大兒的發(fā)生情況進(jìn)行比較,差異顯著,具有統(tǒng)計(jì)學(xué)意義(P＜0.05),孕婦孕前體重增加越大,其在妊娠期間妊娠期糖尿病、妊娠期高血壓疾病、高出生體重新生兒甚至巨大兒的發(fā)生概率越大。 3)對孕前體重各組的孕婦進(jìn)行產(chǎn)后出血、胎兒窘迫、新生兒窒息、新生兒病理性黃疸方面的分析,差異不顯著,沒有統(tǒng)計(jì)學(xué)意義(P＞0.05)。 4)對孕期增重各組之間新生兒高出生體重、巨大兒、妊娠期高血壓疾病、妊娠期糖尿病的發(fā)生情況比較,差異顯著,具有統(tǒng)計(jì)學(xué)意義(P＜0.05)。伴隨孕婦在孕期的體重增加,妊娠期高血壓疾病、妊娠期糖尿病發(fā)病率增加,新生兒的出生體重增加,且巨大兒的發(fā)生率也逐漸增加(P＜0.01)。 5)對孕期增重各組之間新生兒病理性黃疸、新生兒窒息、胎兒窘迫、產(chǎn)后出血、難產(chǎn)剖宮產(chǎn)、產(chǎn)程阻滯發(fā)生情況比較,差異不顯著,沒有重要的統(tǒng)計(jì)學(xué)意義(P＞0.05)。 結(jié)論 適當(dāng)控制孕前體重,保證合理孕期增重,能夠顯著地降低難產(chǎn)剖宮產(chǎn)、產(chǎn)程阻滯、妊娠期糖尿病、妊娠期高血壓疾病的發(fā)生概率,明顯降低新生兒的出生體重,巨大兒的發(fā)生概率也相應(yīng)的明顯減少,能夠更好、更科學(xué)、更合理地指導(dǎo)臨床孕婦的孕期保健,促使母兒獲得理想的營養(yǎng)。此次研究結(jié)果表明,孕婦的最佳孕前體重范圍是：18.5≤BMI＜23,最佳的孕期體重增長范圍是：△W＜15kg
[Abstract]:Objective to analyze the correlation between different body weight of pregnant women before pregnancy and weight gain during pregnancy, pregnancy outcome and common complications of obstetrics, and to explore the weight gain during pregnancy and the appropriate range of weight gain during pregnancy, so as to guide the health care during pregnancy. Reasonable individualized weight management is established to greatly reduce the probability of complications during delivery and in the third trimester of pregnancy. Methods the pregnant women who met the conditions of delivery in Linyi Maternal and Child Health Hospital (Grade 3A Maternal and Child Health Hospital) were examined prospectively, and the standard operating rules were used to measure accurately. The height and weight of the pregnant woman were measured by taking off shoes. The height of the pregnant woman was recorded, and the weight of the pregnant woman one month before pregnancy and the weight of the pregnant woman (the weight of the pregnant woman at the time of delivery) were recorded. The occurrence of complications during pregnancy (hypertensive disorder complicating pregnancy and gestational diabetes mellitus), the final mode of delivery, the birth weight and Alzheimer's score of newborns, the complications of macrosomia and parturients, and the data collected and sorted out. The weight gain map of pregnant women was drawn, and the body mass index (BMI) of pregnant women before pregnancy was calculated, that is, the weight gain of pregnant women was (kg) / height (m) 2. The weight gain during pregnancy was the difference between the weight gain before pregnancy and the weight before pregnancy. The pregnant women were divided into four groups: obese group (BMI 鈮，

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