宿迁地区高龄产妇孕前体质指数、孕期增重情况及血红蛋白水平对小于胎龄儿出生状况的影响研究
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摘要
目的探讨宿迁地区高龄产妇孕前体质指数(body mass index,BMI)、孕期增重情况及血红蛋白(hemoglobin, Hb)水平对小于胎龄儿(small for gestational age infant,SGA)出生状况的影响。方法选取2015年12月至2017年12月于徐州医科大学附属医院建立孕产妇保健手册并定期产检与分娩的1363例高龄产妇为研究对象,比较不同临床资料的高龄产妇分娩情况,采用多因素Logistic回归分析探讨SGA出生的独立危险因素。结果 1363例高龄产妇分娩的新生儿中共有205例诊断为SGA,总发生率为15.0%。初产妇、孕前BMI <18.5 kg/m~2、孕期增重不足的高龄产妇分娩的SGA均显著增加(P_均<0.05)。多因素Logistic回归分析显示:孕前BMI <18.5 kg/m~2、孕期增重不足是SGA出生的独立危险因素(OR=2.039,95%CI:1.343~3.095,P <0.05;OR=1.832,95%CI:1.200~2.798,P <0.05),而孕期增重过度是SGA出生的独立保护因素(OR=0.696,95%CI:0.501~0.967,P <0.05)。结论宿迁地区高龄产妇孕前BMI <18.5 kg/m2与孕期增重不足是SGA出生的独立危险因素,而孕期Hb水平对SGA的出生无明显影响。
Objective To investigate the effect of pregestational body mass index(BMI),gestational weight gain and hemoglobin(Hb) level on the birth status of small for gestational age infant(SGA) in elderly parturient in Suqian area.Method 1363 elderly parturient who had established maternal health handbook and regular obstetric examination and delivered in the Affiliated Hospital of Xuzhou Medical University from December 2015 to December 2017 were enrolled for the study.The delivery conditions of elderly parturient with different clinical data were compared.Multivariate Logistic regression was performed to analyze the independent related factors of SGA.Result In all 1363 elderly parturient,205 meonates had delivered SGA with a total incidence of 15.0%.The SGA of primipara,pregestational BMI<18.5 kg/m2 and insufficient weight gain during pregnancy were significantly increased(P_(all)<0.05).Multivariate Logistic regression analysis showed that pregestational BMI<18.5 kg/m~2 and insufficient weight gain during pregnancy were the independent risk factors of SGA(OR=2.039,95%CI:1.343~3.095,P<0.05;OR=1.832,95%CI:1.200~2.798,P<0.05),and excessive weight gain during pregnancy was an independent protective factor of SGA(OR=0.696,95%CI:0.501~0.967,P<0.05).Conclusion Pregestational BMI<18.5 kg/m~2 and insufficient gestational weight gain of elderly parturient in Suqian area are the independent related factors of SGA,while serum Hb level during pregnancy has no significant effect on SGA.
Objective To investigate the effect of pregestational body mass index(BMI),gestational weight gain and hemoglobin(Hb) level on the birth status of small for gestational age infant(SGA) in elderly parturient in Suqian area.Method 1363 elderly parturient who had established maternal health handbook and regular obstetric examination and delivered in the Affiliated Hospital of Xuzhou Medical University from December 2015 to December 2017 were enrolled for the study.The delivery conditions of elderly parturient with different clinical data were compared.Multivariate Logistic regression was performed to analyze the independent related factors of SGA.Result In all 1363 elderly parturient,205 meonates had delivered SGA with a total incidence of 15.0%.The SGA of primipara,pregestational BMI<18.5 kg/m2 and insufficient weight gain during pregnancy were significantly increased(P_(all)<0.05).Multivariate Logistic regression analysis showed that pregestational BMI<18.5 kg/m~2 and insufficient weight gain during pregnancy were the independent risk factors of SGA(OR=2.039,95%CI:1.343~3.095,P<0.05;OR=1.832,95%CI:1.200~2.798,P<0.05),and excessive weight gain during pregnancy was an independent protective factor of SGA(OR=0.696,95%CI:0.501~0.967,P<0.05).Conclusion Pregestational BMI<18.5 kg/m~2 and insufficient gestational weight gain of elderly parturient in Suqian area are the independent related factors of SGA,while serum Hb level during pregnancy has no significant effect on SGA.
引文
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[13]杨海清,阎相杉,闫刚,等.全市妇女孕前体质指数、孕期增重对新生儿出生体格的影响分析[J].转化医学电子杂志,2017,4(1):51-52.
[14]李晴,徐蓉,徐叶清,等.孕前低BMI与小于胎龄儿关系[J].中国公共卫生,2013,29(7):950-952.
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[16]Dello Russo M,Ahrens W,De Vriendt T,et al.Gestational weight gain and adiposity,fat distribution,metabolic profile,and blood pressure in offspring:the IDEFICS project[J].Int JObes(Lond),2013,37(7):914-919.
[17]Stamnes Koepp UM,Frost Andersen L,Dahl-Joergensen K,et al.Maternal pre-pregnant body mass index,maternal weight change and offspring birthweight[J].Acta Obstet Gynecol Scand,2012,91(2):243-249.
[18]李元元,马志敏,刘洁,等.孕期体重管理与产后盆底功能损伤的相关性研究[J].中国医学前沿杂志(电子版),2018,10(7):64-67.
[19]郑盈,杨芩,祝娟,等.孕期营养体质量干预管理与妊娠结局的关系[J].转化医学电子杂志,2016,3(10):14-16.
[20]李辉霞,冯娜,郑剑飞,等.5012名单胎活产儿小于胎龄儿和大于胎龄儿发生率及其影响因素研究[J].中国儿童保健杂志,2017,25(5):463-466,477.
[2]黎萍,钟鑫琪,梁少珍,等.小于胎龄儿危险因素550例分析[J].中国儿童保健杂志,2014,22(7):773-775.
[3]钟鑫琪,崔其亮.早产儿和小于胎龄儿发生的危险因素的比较分析[J].中国当代儿科杂志,2014,16(12):1202-1205.
[4]李燕华,何玮,吴小芳,等.超声引导下局部注射甲氨蝶呤联合子宫动脉栓塞术治疗高龄产妇剖宫产术后子宫瘢痕妊娠的临床效果[J].中国医学前沿杂志(电子版),2018,10(8):65-68.
[5]周辉,闫清波.320例高龄产妇临床妊娠分析[J].中国计划生育和妇产科,2015,7(6):60-62,66.
[6]朱丽,张蓉,张淑莲,等.中国不同胎龄新生儿出生体重曲线研制[J].中华儿科杂志,2015,53(2):97-103.
[7]Leung T,Leung T,Sahota D,et al.Trend in maternal obesity and associated risks of adverse pregnancy outcomes in a population of China women[J].BJOG,2008,115(12):1529-1537.
[8]张瑜君,邬俏璇.600例高龄产妇临床妊娠常见状况分析[J].齐齐哈尔医学院学报,2016,37(1):28-29.
[9]李媛媛,张海鲲,李忠良,等.不良妊娠结局现状及其影响因素分析[J].中国妇幼健康研究,2014,25(4):577-580.
[10]姚雪梅,丁桂凤.产妇高龄对妊娠合并症及妊娠结局影响的研究[J].实用预防医学,2017,24(10):1200-1204.
[11]邹晓萍,邹晓文,刘传,等.35岁以上初产妇不良妊娠结局及其相关危险因素分析[J].中国计划生育和妇产科,2018,10(3):57-61.
[12]赵光临.深圳市2008年高龄产妇妊娠结局分析[J].中国妇幼保健,2010,25(21):2948-2950.
[13]杨海清,阎相杉,闫刚,等.全市妇女孕前体质指数、孕期增重对新生儿出生体格的影响分析[J].转化医学电子杂志,2017,4(1):51-52.
[14]李晴,徐蓉,徐叶清,等.孕前低BMI与小于胎龄儿关系[J].中国公共卫生,2013,29(7):950-952.
[15]Yan J.Maternal pre-pregnancy BMI,gestational weight gain,and infant birth weight:a within-family analysis in the United States[J].Econ Hum Biol,2015,18:1-12.
[16]Dello Russo M,Ahrens W,De Vriendt T,et al.Gestational weight gain and adiposity,fat distribution,metabolic profile,and blood pressure in offspring:the IDEFICS project[J].Int JObes(Lond),2013,37(7):914-919.
[17]Stamnes Koepp UM,Frost Andersen L,Dahl-Joergensen K,et al.Maternal pre-pregnant body mass index,maternal weight change and offspring birthweight[J].Acta Obstet Gynecol Scand,2012,91(2):243-249.
[18]李元元,马志敏,刘洁,等.孕期体重管理与产后盆底功能损伤的相关性研究[J].中国医学前沿杂志(电子版),2018,10(7):64-67.
[19]郑盈,杨芩,祝娟,等.孕期营养体质量干预管理与妊娠结局的关系[J].转化医学电子杂志,2016,3(10):14-16.
[20]李辉霞,冯娜,郑剑飞,等.5012名单胎活产儿小于胎龄儿和大于胎龄儿发生率及其影响因素研究[J].中国儿童保健杂志,2017,25(5):463-466,477.