妇女孕前体重指数对晚期早产儿不良结局的影响

Association between maternal pre-pregnancy body mass index and adverse outcomes of late preterm infants

摘要:

目的 探讨妇女孕前体重指数（BMI）与晚期早产儿（LPI）不良结局的关系。方法 选择2011年1月至2015年12月的367例住院LPI为研究对象。分析母亲孕前BMI水平的相关因素，以及与LPI不良结局（1 min Apgar评分≤7分、产房复苏、住院天数 > 7 d以及呼吸机通气时间≥6 h）的关系。结果 母亲孕前BMI降低、正常、增高的分别有64例（17.4%）、243例（66.2%）以及60例（16.4%）。母亲孕前BMI降低是LPI 1 min Apgar评分≤7分（OR=3.243，95%CI：1.102~9.546）和需要产房复苏（OR=3.492，95%CI：1.090~11.190）的危险因素，孕前高BMI是LPI住院时间 > 7 d（OR=1.992，95%CI：1.024~3.874）的危险因素。结论 妇女孕前BMI对LPI结局产生影响，建议妇女孕前控制BMI水平在正常范围内，减少LPI不良结局发生。

Abstract:

Objective To study the association between maternal pre-pregnancy body mass index (BMI) and adverse outcomes of late preterm infants (LPI). Methods A total of 367 LPI who were born from January 2011 to December 2015 and admitted to the neonatal ward were enrolled. The BMI criteria for Chinese population were used to analyze the factors for maternal pre-pregnancy BMI and its association with adverse outcomes of LPI (1 minute Apgar score ≤ 7, delivery room resuscitation, hospitalization days after birth > 7 days, and ventilation duration ≥ 6 hours). Results Of all LPIs, there were 64 LPI (17.4%) in the low maternal pre-pregnancy BMI group, 243 LPI (66.2%) in the normal maternal pre-pregnancy BMI group, and 60 LPI (16.4%) in the high maternal pre-pregnancy BMI group. Low pre-pregnancy BMI was the risk factor for 1 minute Apgar score ≤ 7 (OR=3.243, 95%CI:1.102-9.546) and need for delivery room resuscitation (OR=3.492, 95%CI:1.090-11.190), and high pre-pregnancy BMI was the risk factor for hospitalization days after birth > 7 days (OR=1.992, 95%CI:1.024-3.874). Conclusions Abnormal maternal pre-pregnancy BMI has adverse effects on the outcomes of LPI. In order to reduce these adverse outcomes BMI should be controlled within the normal range in pregnant women.