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目的:评估美国科学院医学院(IOM)孕期体质量控制标准是否适用于上海地区孕妇。方法:回顾性收集2014年1月至2015年3月于同济大学附属第一妇婴保健院分娩产妇的孕期体质量变化及妊娠结局资料,按WHO体质量分类标准将孕前体质量分为体质量过低组、正常组、超重组、肥胖组,按孕期体质量控制是否符合IOM标准进行分组(未达标、达标、超标),比较不同组别包括出生体质量在内的各种妊娠结局,分析IOM体质量控制标准在上海地区人群中的适用情况。结果:纳入研究资料齐全孕妇6915例,体质量过低、正常、超重、肥胖的孕妇分别占15.7%(1086例)、76.4%(5281例)、7.3%(502例)及0.7%(46例),仅43.3%(2991/6915)孕妇孕期体质量控制达到IOM体质量控制标准。未达标、达标及超标组间,除低体质量组的巨大儿发生率,正常组的子痫前期、妊娠期糖尿病、剖宫产率、巨大儿发生率、低出生体质量及巨大儿总发生率,超重组的妊娠期糖尿病、巨大儿发生率外,其余差异均无统计学意义(P>0.05)。孕期体质量变化与低出生体质量儿及巨大儿联合风险曲线图显示,当孕期体质量控制低于IOM时,风险最低。结论:IOM推荐孕期体质量控制范围不适用于上海地区孕妇,上海地区孕妇可能需要更严格的孕期体质量控制以改善包括新生儿出生体质量在内的妊娠结局。
PURPOSE: To assess whether the pregnancy control of the American Academy of Medical Sciences (IOM) is applicable to pregnant women in Shanghai. Methods: A retrospective study was conducted to collect data on pregnancy weight changes and pregnancy outcomes of pregnant women during delivery from January 2014 to March 2015 in Tongji University. According to the WHO classification of body mass, pregnant women were divided into body weight (Normal group, overweight group and obesity group) were grouped according to whether IOM standard was used in pregnancy control. The pregnancy outcomes were analyzed in different groups including birth weight, IOM body quality control standards in the Shanghai population in the application of the situation. Results: A total of 6,915 pregnant women were enrolled in the study, and 15.7% (1086 cases), 76.4% (5281 cases), 7.3% (502 cases) and 0.7% (46 cases) of normal, overweight and obese pregnant women, ), Only 43.3% (2991/6915) pregnant women pregnant women body mass control IOM body mass control standards. The incidence of macrosomia in low-quality group, pre-eclampsia, gestational diabetes mellitus, cesarean section rate, the incidence of macrosomia, low birth weight and total macrosomia Rate, overweight group of gestational diabetes mellitus, macrosomia incidence, the other differences were not statistically significant (P> 0.05). Pregnancy and body mass changes in low birth weight children and giant children combined risk curve showed that when the body weight control during pregnancy lower than IOM, the lowest risk. CONCLUSIONS: IOM recommended that the control of body mass during pregnancy does not apply to pregnant women in Shanghai. Pregnant women in Shanghai may need more stringent control of pregnancy weight to improve pregnancy outcomes, including the birth weight of newborns.