李昭润, 蒋泓, 钱序. 孕前体质量指数对妊娠期疾病及妊娠结局的影响[J]. 上海预防医学, 2020, 32(7): 545-553. DOI: 10.19428/j.cnki.sjpm.2020.19927
引用本文: 李昭润, 蒋泓, 钱序. 孕前体质量指数对妊娠期疾病及妊娠结局的影响[J]. 上海预防医学, 2020, 32(7): 545-553. DOI: 10.19428/j.cnki.sjpm.2020.19927
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LI Zhao-run, JIANG Hong, QIAN Xu. Effect of pre-pregnancy BMI on gestational diseases and pregnancy outcomes[J]. Shanghai Journal of Preventive Medicine, 2020, 32(7): 545-553. DOI: 10.19428/j.cnki.sjpm.2020.19927
Citation: LI Zhao-run, JIANG Hong, QIAN Xu. Effect of pre-pregnancy BMI on gestational diseases and pregnancy outcomes[J]. Shanghai Journal of Preventive Medicine, 2020, 32(7): 545-553. DOI: 10.19428/j.cnki.sjpm.2020.19927
shu

孕前体质量指数对妊娠期疾病及妊娠结局的影响

Effect of pre-pregnancy BMI on gestational diseases and pregnancy outcomes

    摘要
  • 摘要:
    目的研究孕前体质量指数(BMI)对妊娠期疾病和妊娠结局的影响。
    方法检索涉及中国、美国、加拿大、越南以及印度尼西亚5个国家、2014—2019年国内外相关文献773篇，依照纳入排除标准最终纳入8篇队列研究，描述孕前女性BMI分布情况以及孕前BMI与妊娠期疾病或妊娠结局的关系。
    结果孕前BMI过低可导致母亲产后出血(OR=7.1, 95%CI：2.7~13.6)、急性肾衰竭(OR=1.6, 95%CI:0.1~5.3)、新生儿低出生体重(OR=3.1, 95%CI：1.5~6.2)、小于胎龄儿(OR=2.9, 95%CI:1.9~4.5)等疾病的风险增高；孕前BMI过高会导致先兆子痫(OR=1.09, 95%CI:1.04~1.14)、妊娠期高血压(OR=5.49~11.42)、剖宫产(OR=1.94, 95%CI:1.80~2.08)、产科干预并发症(OR=4.4~8.2)以及生出巨大儿(OR=2.36, 95%CI:2.15~2.59)等疾病的发生风险增高；自发性流产、异位妊娠等疾病也与孕前BMI异常(过高或过低)显著相关。
    结论孕前BMI与妊娠期高血压、先兆子痫、妊娠期糖尿病等严重孕产妇疾病及早产、异常出生体重、剖宫产等诸多不良妊娠结局存在显著相关关系，但该领域需更多基于人群的大样本前瞻性队列研究为孕前体重管理提供更强有力证据。

     

    Abstract:
    ObjectiveTo explore the effect of body mass index before pregnancy on various gestational diseases and adverse pregnancy outcomes.
    MethodsRelated cohort studies at home and abroad from 2014 to 2019 in China, the United States, Canada, Vietnam and Indonesia were reviewed to evaluate the effects of pre-pregnancy BMI on the risk of gestational disease and pregnancy outcomes.The number of 773 articles was collected and 8 cohort studies were selected in accordance with the inclusion criteria for this study.
    ResultsLow pre-pregnancy BMI could significantly increase the risk of postpartum hemorrhage (OR=7.1, 95%CI:2.7-13.6), acute renal failure (OR=1.6, 95%CI:0.1-5.3), low birth weight (OR=3.1, 95%CI:1.5-6.2), less than gestational age (OR=2.9, 95%CI: 1.9-4.5) and so on.High pre-pregnancy BMI could significantly increase the risk of preeclampsia (OR=1.09, 95%CI:1.04- 1.14), gestational hypertension (OR=5.49-11.42), cesarean section (OR=1.94, 95%CI:1.80-2.08), obstetric complications (OR=4.4-8.2), fetal macrosomia (OR=2.36, 95%CI:2.15-2.59) and other diseases.Spontaneous abortion, ectopic pregnancy were significantly associated with abnormal pre-pregnancy BMI (too high or too low).
    ConclusionPre-pregnancy BMI is significantly associated with severe maternal diseases such as gestational hypertension, preeclampsia, gestational diabetes and adverse pregnancy outcomes like premature birth, abnormal birth weight, cesarean section.It suggests that more population-based prospective cohort studies are needed in this field to provide stronger evidence for pre-pregnancy weight management.

     

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