妊娠前肥胖对胎儿生长受限妊娠结局的影响

发育医学电子杂志

2017, Vol. 5

Issue (2): 98-101

围产医学论著｜产科

妊娠前肥胖对胎儿生长受限妊娠结局的影响

许桂杰^1,2　尚丽新¹

1.陆军总医院　妇产科，北京　100700； 2.大连医科大学第一临床学院　妇产科，辽宁　大连　116044

Influence of obesity before pregnancy on pregnant outcome of fetal growth restriction

XU Gui-jie ^1,2, SHANG Li-xin¹

1. Department of Obstetrics & Gynecology, PLA Army General Hospital, Beijing 100700, China; 2. Department of Obstetrics & Gynecology, First Clinical College, The Medical University of Dalian, Liaoning, Dalian 116044, China)

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摘要目的　探讨妊娠前肥胖对胎儿生长受限（fetal growth restriction，FGR）患者妊娠结局的影响。方法　2011年4月1日至2016年3月31日，在陆军总医院妇产科就诊的孕妇中，纳入定期产检、单胎妊娠、自然受孕、无胎儿畸形、产前和生后诊断FGR的213例孕妇为研究对象。根据妊娠前体重指数（body mass index，BMI）分为正常、超重和肥胖3组，比较3组孕妇的一般情况、并发症发生情况和围产儿死亡情况。采用方差分析、χ ²检验和Fisher确切概率法进行统计学分析。结果　 3组孕妇的年龄、孕次、产次比较，差异均无统计学意义（P﹥0.05）。肥胖组以下各项指标的比例均高于正常组和超重组：剖宫产率［86.7%（26/30）与47.4%（54/114）、79.7%（55/69）］、围产儿死亡率［13.3%（4/30）与0.0%（0/114）、1.5%（1/69）］、胎盘异常发生率［23.3%（7/30）与5.3%（6/114）、10.1%（7/69）］、妊娠期糖尿病发生率［23.3%（7/30）与6.1%（7/114）、15.9%（11/69）］、子痫前期发生率［26.7%（8/30）与10.5%（12/114）、21.7%（15/69）］。肥胖组8例子痫前期中，子痫重度有4例，均发生围产儿死亡。结论　肥胖孕妇发生FGR，要警惕妊娠期及分娩期并发症的发生风险，合理干预，改善妊娠结局。

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关键词: 肥胖')" href="#">">肥胖胎儿生长受限并发症分娩方式

Abstract: Objective To investigate the influence of obesity before pregnancy on pregnant outcome in fetal growth restriction (FGR) patients. Methods　From April 1st, 2011 to March 31st, 2016, 213 pregnant women in the department of obstetrics & gynecology, PLA Army General Hospital were enrolled according to the following criteria: regular prenatal examination, single pregnancy, natural pregnancy, without fetal malformations, and being diagnosed as FGR before and after delivery. According to the body mass index (BMI) before pregnancy, 213 cases were divided into three groups, which were normal, overweight and obese groups. The general situation, complications and deaths of perinatal infants were compared among the three groups. Statistical analysis was performed by variance analysis, χ² test and Fisher's exact test. Results　 There were no significant differences in the age, gravidity and parity of the three groups (P>0.05). The proportion of the following indicators in the obese group was higher than that in the normal group and overweight group: cesarean section ［86.7% (26/30) vs 47.4% (54/114) and 79.7% (55/69)］, deaths of perinatal infants ［13.3% (4/30) vs 0.0% (0/114) and 1.5% (1/69)］, placental abnormalities ［23.3% (7/30) vs 5.3% (6/114) and 10.1% (7/69)］, gestational diabetes mellitus ［23.3% (7/30) vs 6.1% (7/114) and 15.9% (11/69)］, and preeclampsia ［26.7% (8/30) vs 10.5% (12/114) and 21.7% (15/69)］. In the 8 preeclampsia cases of obese group, 4 cases were severe eclampsia and occurred death of perinatal infants. Conclusions Obese pregnant women with FGR should pay attention to the risk of complications in pregnancy and delivery and intervene reasonably to improve the pregnant outcome.

Key words: Obesity')" href="#">">Obesity Fetal growth restriction Complication Mode of delivery

收稿日期: 2016-11-19 出版日期: 2017-04-30 发布日期: 2018-01-17 期的出版日期: 2017-04-30

通讯作者: 尚丽新：妇产科主任，主任医师，教授，博士后工作站导师，博士研究生导师，硕士研究生导师。享受国务院政府特殊津贴，并三次享受军队特殊人才岗位津贴。 E-mail: 19932003@163.com

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许桂杰, 　尚丽新. 妊娠前肥胖对胎儿生长受限妊娠结局的影响[J]. 发育医学电子杂志, 2017, 5(2): 98-101.
XU Gui-jie, SHANG Li-xin. Influence of obesity before pregnancy on pregnant outcome of fetal growth restriction. Journal of Developmental Medicine(Electronic Version), 2017, 5(2): 98-101.

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