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目的探讨孕前体质指数(BMI)与4种不良妊娠结局(小于胎龄儿、大于胎龄儿、低出生体重儿、巨大儿)的关系。方法以2008年10月—2010年10月在安徽省8个地市的妇幼保健机构孕早期建卡并随访到分娩记录的12 355名孕妇为对象,采用χ2检验和非条件Logistic回归分析模型,分析孕前BMI与4种不良妊娠结局的关系。结果孕妇孕前BMI均数为(20.19±2.348)kg/m2,过低2 834人(22.9%),正常8 745人(70.8%),超重及肥胖776人(6.3%);调整年龄、户籍地、孕次等混杂因素后,对孕前BMI与胎龄儿组和体重儿组分别进行关联性分析,结果显示,孕前BMI过低是发生小于胎龄儿的危险因素(OR=1.320,95%CI=1.068～1.631);孕前超重及肥胖是发生大于胎龄儿和巨大儿的危险因素(OR=1.758,95%CI=1.503～2.056;OR=1.870,95%CI=1.540～2.271)。结论孕前BMI过低或者过高均会影响妊娠结局。
Objective To investigate the relationship between pre-pregnancy body mass index (BMI) and four unfavorable pregnancy outcomes (less than gestational age, over gestational age, low birth weight children, giant children). Methods From October 2008 to October 2010, 12 355 pregnant women whose maternal and child health institutions in 8 cities in Anhui Province established their cards during the first trimester of pregnancy and were followed up to the birth record were analyzed by χ2 test and non-conditional logistic regression analysis. Analysis of the relationship between pre-pregnancy BMI and 4 adverse pregnancy outcomes. Results The mean BMI before pregnancy was (20.19 ± 2.348) kg / m2, 2 834 (22.9%), 8 745 (70.8%) and 776 (6.3%) overweight and obesity. The adjusted age, , Pregnancy and other confounding factors, the pre-pregnancy BMI and gestational age groups and weight-bearing children were analyzed separately, the results showed that pre-pregnancy BMI is less risk factors for children younger than gestational age (OR = 1.320,95% CI = 1.068-1.631). Overweight and obesity before pregnancy were the risk factors for children older than gestational age and giant macrosomia (OR = 1.758, 95% CI = 1.503-2.05; OR = 1.870, 95% CI = 1.540-2.271). Conclusion Pre-pregnancy BMI is too low or too high will affect the pregnancy outcome.