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糖耐量正常孕妇的孕前体重指数和孕期体重增加对围产期结局的影响。

Effects of prepregnancy body mass index and weight gain during pregnancy on perinatal outcome in glucose-tolerant women.

机构信息

Department of Internal Medicine, University of Messina, Messina, Italy.

出版信息

Diabetes Metab. 2012 Feb;38(1):63-7. doi: 10.1016/j.diabet.2011.07.005. Epub 2011 Oct 1.

Abstract

AIM

The aim of this study was to determine the effects of maternal prepregnancy body mass index (BMI) and weight gain during pregnancy on perinatal outcome in non-diabetic women.

METHODS

The clinical records of consecutive women who had undergone a glucose challenge test (GCT) and then delivered in our university hospital between January 2004 and December 2009 were retrospectively reviewed. Prepregnancy BMI and pregnancy weight gain were classified according to the US Institute of Medicine guidelines (1990).

RESULTS

Of the eligible 2225 patients, obese and overweight women had a greater percentage of macrosomic babies (17.7% and 8.9%, respectively) compared with normal weight women (4.5%). However, when considered according to weight gain during pregnancy, the results were statistically significant only for excess weight gain in the obese (OR: 8.3, 95% CI: 2.4-28.4) and overweight (OR: 2.9, 95% CI: 1.2-6.8) groups. Also, the surgical delivery rate was significantly higher in the obese vs normal weight women (56% vs 36%, respectively) although, in this case, there was no difference according to normal and excess weight gain during pregnancy (OR: 1.4, 95% CI: 0.7-2.6).

CONCLUSION

Overweight and obese women have an increased risk rate of macrosomia that can be limited by well-controlled weight gain during pregnancy. There was also a significantly higher rate of surgical delivery in the obese compared with the normal weight group that was, however, independent of excessive weight gain during pregnancy.

摘要

目的

本研究旨在探讨孕前体重指数(BMI)和孕期体重增加对非糖尿病妇女围产期结局的影响。

方法

回顾性分析 2004 年 1 月至 2009 年 12 月在我院行葡萄糖筛查试验(GCT)并分娩的连续孕妇的临床资料。根据美国医学研究所(IOM)指南(1990 年)对孕前 BMI 和孕期体重增加进行分类。

结果

在 2225 例符合条件的患者中,肥胖和超重妇女的巨大儿发生率(分别为 17.7%和 8.9%)明显高于正常体重妇女(4.5%)。然而,当根据孕期体重增加进行考虑时,仅肥胖(OR:8.3,95%CI:2.4-28.4)和超重(OR:2.9,95%CI:1.2-6.8)组的结果具有统计学意义。此外,肥胖组的剖宫产率明显高于正常体重组(56% vs 36%),尽管在这种情况下,根据孕期正常和超重体重增加,剖宫产率无差异(OR:1.4,95%CI:0.7-2.6)。

结论

超重和肥胖妇女发生巨大儿的风险率增加,通过良好控制孕期体重增加可以降低风险。肥胖组的剖宫产率明显高于正常体重组,但与孕期体重过度增加无关。

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