现代妇产科进展2026，Vol.35Issue(5)：353-356,4.DOI:10.13283/j.cnki.xdfckjz.2026.05.004
孕期增重Z评分评估经产妇孕期增重程度对妊娠结局的影响
Gestational weight gain Z-score to evaluate the gestational weight gain in multiparous women and its impact on pregnancy outcomes
摘要
Abstract
Objective:Use the pregnancy weight gain Z-score to evaluate the impact of different pre pregnancy body mass index(BMI)levels of weight gain on pregnancy outcomes in multiparous women.Method:A total of 1014 single pregnancy pregnant women who underwent regular prenatal check-ups and gave birth at Kunshan Maternal and Child Health Hospital from January to December 2024 were selected as the research subjects.They were grouped according to their pre-pregnancy BMI values,followed up on changes in weight gain during pregnancy,and recorded their pregnancy test results,complications,and pregnancy outcomes.Using a Z-score chart specific to pre-pregnancy BMI,standardize weight gain at different gestational weeks into Z-score values for specific gestational weeks,and divide Z-score values into three groups based on<-1,-1～1,and>1:insufficient weight gain,appropriate weight gain,and excessive weight gain.Evaluate the impact of postpartum weight gain on pregnancy outcomes.Results:Z score<-1 or>1 increased the risk of cesarean section(P=0.039),gestational diabetes(P=0.000),and premature delivery(P=0.036).The proportion of gestational hypertension with excessively high Z-scores increased(19.23％vs 7.09％,P=0.046),and the proportion of macrosomia also increased(19.23％vs 6.12％,P=0.040),with statistically significant differ-ences.There was no statistically significant difference(P>0.05)between the degree of weight gain during pregnancy and postpartum hemorrhage,premature rupture of membranes,fetal growth restriction,or intrauterine fetal distress.Logistic regression analysis showed that after controlling age and pre-pregnancy BMI,the lack of weight gain(Z<-1)during pregnancy was a protective factor for cesarean section(OR=0.567,95％CI:0.334～0.962)and diabetes dur-ing pregnancy(OR=0.520,95％CI:0.377～0.717),but it was a risk factor for premature de-livery(OR=1.089,95％CI:1.048～1.132).However,excessive weight gain during pregnancy(Z>1)was a risk factor for cesarean section(OR=1.066,95％CI:1.031～1.102),hyperten-sive disorder during pregnancy(OR=1.196,95％CI:1.128～1.268),and diabetes during pregnancy(OR=1.110,95％CI:1.066～1.156).Conclusion:Insufficient or excessive weight gain during pregnancy in multiparous women can lead to adverse pregnancy outcomes.The Z-score has certain clinical significance in evaluating weight gain during pregnancy and dynami-cally observing and following up on weight changes.关键词
经产妇/妊娠期体重增长/Z评分Key words
Postpartum women/Gestational Weight gain/Z-score分类
医药卫生引用本文复制引用
张琴静,怀莹莹,费晓萍..孕期增重Z评分评估经产妇孕期增重程度对妊娠结局的影响[J].现代妇产科进展,2026,35(5):353-356,4.基金项目
昆山市市级科技专项(No:KSZ2518) （No:KSZ2518）
