孕前BMI及孕期BMI变化对产妇分娩方式及围产期结局的影响分析

Analysis of the effects of BMI before pregnancy and changes in pregnancy BMI on delivery modes and perinatal outcomes

摘要

目的 分析孕前体质指数(BMI)及孕期BMI变化对产妇分娩方式、围产期结局的影响,为备孕期及孕期女性的体重管理提供依据。方法 选取2022年8月至2023年8月在昆明市妇幼保健院住院分娩的98例孕妇作为研究对象,按孕前BMI将研究对象分为消瘦组(n=16)、正常组(n=54)、超重或肥胖组(n=28);按孕期BMI变化分为增重不足组(n=19)、增重正常组(n=27)、增重过多组(n=52),分析组间孕妇分娩方式及围产期结局的差异。结果 98例孕妇中,69例行阴道分娩,29例行剖宫产.消瘦组、正常组、超重或肥胖组孕妇分娩方式比较差异具有统计学意义(χ²值为11.068,P<0.05);增重不足组、增重正常组及增重过多组的孕妇分娩方式比较差异具有统计学意义(χ²值为9.126,P<0.05).消瘦组、正常组、超重或肥胖组的妊娠并发症、胎儿不良事件、新生儿不良事件比例比较差异具有统计学意义(χ²值分别为13.411、21.977、23.885,P<0.05),而产后并发症比例的差异无统计学意义(P>0.05);不同孕期BMI变化组别的妊娠并发症、胎儿不良事件、新生儿不良事件及产后并发症比例比较差异均具有统计学意义(χ²值分别为11.651、10.825、16.534、11.159,P<0.05)。结论 孕前超重或肥胖、孕期增重过多均可能增加产妇剖宫产及不良围产期结局的发生风险.建议孕前超重或肥胖的妇女在备孕期间进行减重管理,孕期仍需科学管理体重,避免孕期增重过多或增重不足.

Abstract

Objective To analyze the effects of body mass index (BMI) before pregnancy and changes in pregnancy BMI on delivery modes and perinatal outcomes, so as to provide a basis for weight management of women preparing for pregnancy and pregnancy. Methods A total of 98 pregnant women who were hospitalized for delivery in Kunming Maternal and Child Health Hospital from August 2022 to August 2023 were selected as the study subjects, and the subjects were divided into wasting group (n=16), normal group (n=54), and overweight or obese group (n=28) according to pre-pregnancy BMI. According to the changes of BMI during pregnancy, the women were divided into insufficient weight gain group (n=19), normal weight gain group (n=27) and excessive weight gain group (n=52), and the differences in delivery modes and perinatal outcomes between the groups were analyzed. Results Among the 98 pregnant women, 69 underwent vaginal delivery and 29 underwent cesarean section. There were statistically significant differences in delivery modes among the wasting group, normal group, and overweight or obese groups (χ²=11.068, P<0.05), and there were significant differences in delivery modes among underweight group, normal weight gain group and overweight group (χ²=9.126, P<0.05). There were statistically significant differences in the proportions of pregnancy complications, fetal adverse events and neonatal adverse events among the wasting group, normal group and overweight or obesity group (χ²=13.411, 21.977, 23.885, respectively, P<0.05), while there was no significant difference in the proportion of postpartum complications (P>0.05). There were statistically significant differences in pregnancy complications, fetal adverse events, and neonatal adverse events among different groups of BMI changes during pregnancy (χ²=11.651, 10.825, 16.534, 11.159, respectively, P<0.05). Conclusion Overweight or obesity before pregnancy and excessive weight gain during pregnancy may increase the risk of cesarean section and adverse perinatal outcomes. It is recommended that women who are overweight or obese before pregnancy should manage their weight loss during pregnancy, and still need to manage their weight scientifically during pregnancy to avoid excessive or insufficient weight gain during pregnancy.

关键词

孕妇 / 体重指数 / 分娩方式 / 围产期结局

Key words

pregnant women / body mass index / delivery modes / perinatal outcomes

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基金资助

昆明市卫生健康委员会卫生科研课题项目(2022G05G02G011)