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目的了解天津市孕妇中心性肥胖的流行状况,探讨其影响因素,为制定有针对性的预防控制措施提供科学依据。方法以2010年10月至2012年8月在天津市内六区初级卫生保健机构注册的18 043名怀孕4~12周的孕妇为研究对象,测量其腰围水平,腰围≥85.0 cm定义为中心性肥胖,研究其流行状况。用SPSS 20.0软件进行t检验、方差分析和χ2检验,中心性肥胖的影响因素采用logistic回归分析。结果天津市孕妇腰围均值为(78.9±8.7)cm,中心性肥胖率为23.3%。BMI判定为低体重和正常体重组中,中心性肥胖率分别为2.7%和12.0%。多因素logistic回归分析结果显示,年龄大(OR=1.22,95%CI:1.15~1.30),血压水平高(收缩压:OR=1.26,95%CI:1.20~1.33;舒张压:OR=1.29,95%CI:1.20~1.39),有糖尿病家族史、多次妊娠史和吸烟史(OR值分别为1.38、1.13和1.31)的孕妇发生中心性肥胖的危险性增加。与受教育程度≤12年的孕妇比较,受教育时间>12年的孕妇发生中心性肥胖的危险性降低(OR=0.79,95%CI:0.72~0.87)。与月收入<1000元的孕妇比较,月收入为3 000~5 000元及5 000元以上者发生中心性肥胖的危险性降低(OR值分别为0.80和0.69)。结论天津市孕妇平均腰围处于正常水平,但中心性肥胖发生率较高。应针对年龄大、血压高、有糖尿病家族史、吸烟史、多次妊娠史、受教育时间低和月收入水平低的孕妇开展健康教育,预防中心性肥胖的发生。
Objective To understand the prevalence of central obesity in pregnant women in Tianjin and to explore the influencing factors and provide a scientific basis for the development of targeted prevention and control measures. Methods From October 2010 to August 2012, 18 043 pregnant women aged 4 to 12 weeks who were enrolled in six primary health care institutions in Tianjin were enrolled in this study. Their waist circumference was measured. The waist circumference ≥85.0 cm was defined as centrality Obesity, to study its prevalence. SPSS 20.0 software t test, analysis of variance and χ2 test, the influencing factors of central obesity using logistic regression analysis. Results The mean waist circumference of pregnant women in Tianjin was (78.9 ± 8.7) cm and the central obesity rate was 23.3%. The central obesity rates were 2.7% and 12.0% for the BMI-determined body weight and normal body weight groups, respectively. Multivariate logistic regression analysis showed that the patients with older age (OR = 1.22, 95% CI: 1.15-1.30) had higher blood pressure (systolic pressure: 1.26, 95% CI: 1.20-1.33; 95% CI: 1.20-1.39). The risk of central obesity increased in pregnant women with a family history of diabetes, multiple pregnancy history and smoking history (odds ratio, 1.38, 1.13 and 1.31, respectively). Pregnant women> 12 years of education had a reduced risk of developing central obesity (OR = 0.79, 95% CI: 0.72 to 0.87) compared with pregnant women ≤ 12 years of education. Compared with pregnant women whose monthly income was less than 1000 RMB, the risk of central obesity decreased from 3 000 to 5 000 and over 5 000 monthly (OR = 0.80 and 0.69, respectively). Conclusion The average waist circumference of pregnant women in Tianjin is at a normal level, but the incidence of central obesity is higher. Should be aimed at older people, high blood pressure, family history of diabetes, smoking history, multiple pregnancy history, low education and monthly income of pregnant women to carry out health education to prevent the occurrence of central obesity.