摘要
Abstract
Objective To investigate the clinical guidance and evaluative significance of pre-pregnancy body mass index(BMI)and gestational weight gain(GWG)for perinatal outcomes.Methods A total of 310 pregnant women admitted to this hospital from June 2023 to December 2024 were enrolled.Pre-pregnancy BMI was assessed at 6 months before conception.GWG was defined as the highest weight during pregnancy minus the weight 6 months before conception.By pre-pregnancy BMI,participants were assigned to a high pre-pregnancy BMI group(n=20,≥24 kg/m2),a low pre-pregnancy BMI group(n=80,≤18.5 kg/m2),and a normal pre-pregnancy BMI group(n=210,＜24 kg/m2 and＞18.5 kg/m2).By GWG,participants were assigned to a high GWG group(n=40,actual gain above the upper limit of the IOM-recommended range),a low GWG group(n=40,actual gain below the lower limit of the IOM-recommended range),and a normal GWG group(n=230,actual gain within the IOM-recommended range).Perinatal outcomes were compared among groups.Results Among pre-pregnancy BMI groups,neonatal birth weight/length and the proportions of macrosomia,large for gestational age,and small for gestational age differed significantly(P＜0.05).The high pre-pregnancy BMI group had the greatest birth weight and length and the highest proportions of macrosomia and small for gestational age,followed by the normal pre-pregnancy BMI group,with the low pre-pregnancy BMI group lowest;the proportion of large for gestational age was highest in the normal pre-pregnancy BMI group,followed by the high pre-pregnancy BMI group,and lowest in the low pre-pregnancy BMI group(P＜0.05).Mode of delivery differed significantly among the three pre-pregnancy BMI groups(P＜0.05):the cesarean section rate was highest in the low pre-pregnancy BMI group,next in the normal pre-pregnancy BMI group,and lowest in the high pre-pregnancy BMI group;vaginal delivery showed the opposite trend.The incidence of GDM did not differ significantly among the three pre-pregnancy BMI groups(P＞0.05).Among GWG groups,neonatal birth weight/length and the proportions of macrosomia and large for gestational age differed significantly(P＜0.05):the high GWG group had the greatest birth weight and length and the highest proportions of macrosomia and large for gestational age,followed by the normal GWG group,with the low GWG group lowest(P＜0.05).Mode of delivery differed significantly among the GWG groups(P＜0.05):the proportion undergoing cesarean section was highest in the high GWG group,followed by the normal GWG group,and lowest in the low GWG group;vaginal delivery showed the reverse pattern.The incidence of GDM did not differ significantly among the three GWG groups(P＞0.05).Multivariable logistic regression indicated that pre-pregnancy BMI and GWG were associated with pregnancy outcomes and increased the risks of macrosomia and of small or large for gestational age(P＜0.05).Conclusion Appropriate control of pre-pregnancy BMI and GWG can improve adverse pregnancy outcomes to some extent.关键词
孕前BMI/GWG/围生结局/相关性Key words
Pre-pregnancy BMI/GWG/Perinatal outcomes/Correlation分类
医药卫生
