農(nóng)村婦女孕期肥胖對(duì)妊娠結(jié)局的影響
[Abstract]:Objective: To investigate the situation of the obesity of rural women who have been hospitalized in the hospital of Yucheng People's Hospital and to analyze their influence on the outcome of mother-to-child and to explore the methods of the management of body weight during pregnancy to reduce the outcome of the poor pregnancy and to guarantee the safety of the mother and child. Methods: The retrospective cohort study was used in this study to obtain relevant information, such as the age, height, weight of the pregnant woman, the weight before delivery and the outcome of the mother and child, during the period of the pregnant woman's stay in the hospital. The survey of pregnant and delivery of pregnant women in rural pregnant women, which was dedicated to the study, was completed by trained investigators, and 896 cases of single-pregnancy rural women with complete information were collected. The pregnant women were divided into the pregestational age group (BMI18.5 kg/ m2; n = 62) according to the pre-pregnancy BMI; the normal weight of the pregestational weight (18.5 kg/ m2; BMI24 kg/ m2; n = 601); the pre-pregnancy super-recombinant (24 kg/ m2; BMI28 kg/ m2; n = 176); and the pregestational obesity group (BMI = 28 kg/ mm2; n = 57). According to the total weight gain of 15 kg during pregnancy and the increase of BMI in pregnant period, the pregnant women were divided into the appropriate group of weight gain during pregnancy and the weight gain of the pregnant women during pregnancy. The effect of the weight of the pregnant women on the mother-to-child outcome was compared and analyzed. All data were analyzed and processed using the SPSS19.0 statistical software. Results:1. The influence of the maternal body: the pre-pregnancy overweight + obese group and the pre-pregnant body weight normal group, the weight gain of the pregnant women increased over the pre-pregnancy weight gain group, the pregnancy-induced hypertension disease, the gestational diabetes, the cesarean section and the post-partum hemorrhage increased significantly compared with the suitable group in the pre-pregnancy weight gain group. The pre-pregnancy overweight + obesity group was 5.956 times (0R, 5.956;95% CI, 3.474-10.213) of the pre-pregnancy normal body, and the weight gain during pregnancy was 2.777-fold (OR, 2.777;95% CI, 1.558-4.950) in the appropriate group during pregnancy, and the rate of gestational diabetes, The pre-pregnancy overweight + obesity group was 4.212-fold (0R, 4.212;95% CI, 2.547-6.964) of the normal body of pre-pregnancy, and the weight-increasing group during pregnancy was 3.084-fold (0R, 3.084;95% CI, 1.741-5.466) in the appropriate group during pregnancy; at the rate of cesarean section, The pre-pregnancy overweight + obesity group was 2.871-fold (0R, 2.871;95% CI, 2.103-3.919) of the normal body of pre-pregnancy, and the weight-increasing group during pregnancy was 3.317-fold (OR, 3.317;95% CI, 2.470-4.456) in the appropriate group during pregnancy, and in the incidence of postpartum hemorrhage, The pre-pregnancy overweight + obesity group was 5.234-fold (0R, 5.234;95% CI, 2.919-9.385) of the pre-pregnancy normal body, and the weight gain during pregnancy was 2.914-fold (0R, 2.914;95% CI, 1.580-5.374) in the appropriate group during pregnancy. The difference was significant in Chi-square test (P0.01). The effect on the fetus: compared with the normal group in the pre-pregnant and overweight + obese group, the high incidence of the large infant in the pre-pregnant and overweight + obese group was 9.454-fold (0R, 9.454;95% CI, 6.342-14.093) of the pre-pregnancy normal body. The weight gain during pregnancy was 5.108-fold (0R, 5.108;95% CI, 3.248-8.034) in the appropriate group during pregnancy, and the difference was significant in the chi-square test (P0.01); the incidence of neonatal asphyxia in the pregestational obesity was 0.790-fold (0R, 0.790;95% CI, 0.255-2.448) of the pre-pregnancy weight. No statistical significance was found in the chi-square test (X2 = 0.168, P0.05). The incidence of neonatal asphyxia was 1.755 times (0R, 1.755;95% CI, 0.750-4.110) of weight gain during pregnancy, and no statistical significance was found in the chi-square test (X2 = 1.721, P0.05). The risk of over-pregnancy, gestational diabetes, cesarean section, and post-partum hemorrhage during pregnancy was 1.24-fold (95% CI, 1.113-1.388), 1.14-fold (95% CI, 1.023-1.280), 1.37-fold (95% CI, 1.029-1.833), 1.13-fold (95% CI, 1.019-1.243), 2.05 times (95% CI, 1.653-2.545), with statistical significance. In the pre-pregnant and overweight + obese group, compared with the normal group in the pre-pregnant weight group, the weight gain in the pregnant period increased with the appropriate group in the pre-pregnancy weight-increasing group, and the risk of the caesarean section in the large-child line increased, and the result of the chi-square test is statistically significant (P0.01; P0.05); and the risk of the cesarean section is reduced due to the difficult production line, The difference between the two groups was significant (P0.01), and there was no significant difference between the two groups (P0.05). Conclusion: The pre-pregnancy obesity and the increase of the weight of the pregnant women have increased the pregnancy-induced hypertension, the gestational diabetes, the cesarean section, the post-partum hemorrhage, the incidence of the great child, which is the risk factor leading to the poor pregnancy outcome of the pregnant women in the rural areas. In order to mother and child health, the weight management of pregnant women in rural areas should be strengthened, including pre-pregnancy and body weight increase, and the body weight should be controlled within a suitable standard to reduce the occurrence of poor pregnancy outcomes.
【學(xué)位授予單位】:山東大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2017
【分類號(hào)】:R714
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