双绒毛膜双羊膜囊双胎妊娠孕妇孕期增加体质量与围产期结局的相关性研究

Correlation between gestational weight gain and perinatal outcome in dichorionic twin pregnancies

摘要:

目的：探讨双绒毛膜双羊膜囊双胎妊娠孕妇孕期增加体质量与围产期结局的相关性。方法：回顾分析350例符合研究标准的双绒毛膜双羊膜囊双胎孕妇资料，按2009年美国医学研究所（Institute of Medicine，IOM）孕期增加体质量指南推荐，将受试者按孕期增加体质量分为3组：低于指南推荐组（体质量增加＜16.8 kg）145例；符合指南推荐组（16.8 kg≤体质量增加＜24.5 kg）170例；高于指南推荐组（体质量增加≥24.5 kg）35例。记录每例受试者的妊娠并发症发病情况和围产期结局，并采用logistic回归进行相关性分析。结果：妊娠高血压疾病的发生与孕期增加体质量呈正相关（OR=1.087，95%CI=1.008～1.172，P=0.031）。3组孕妇的分娩孕周分别是（35.29±2.25）周、（36.32±1.33）周和（36.50±0.94）周，差异具有统计学意义（P＜0.001）。多因素logistic回归分析显示，极度早产（OR=0.829，95%CI=0.749～0.918，P=0.000）和极度胎膜早破（OR=0.776，95%CI=0.688~0.874，P=0.000）的发生与孕期增加体质量呈负相关，差异具有统计学意义。结论：双绒毛膜双羊膜囊双胎妊娠孕妇中，孕期体质量增加符合IOM指南推荐，有利于减少妊娠并发症的发生以及获得良好的围产期结局。

Abstract:

Objective：To discuss the correlation between gestational weight gain and perinatal outcome in dichorionic twin pregnancies. Methods：Data of 350 dichorionic twin pregnant women meeting the inclusion criteria were retrospectively studied. Specifically they were divided into three groups according to the 2009 US Institute of Medicine US（IOM） recommendations of gestational weight gain（GWG），low GWG group with 145 cases（weight gain＜16.8 kg），recommended GWG group with 170 cases（16.8 kg ≤weight gain＜24.5 kg），and high GWG group with 35 cases（weight gain ≥24.5）. The data of pregnancy complication incidence and perinatal outcome were collected for correlation analysis by multiple logistic regression. Results：The morbidity of gestational hyper-tension was positively correlated with gestational weight gain（OR=1.087，95%CI=1.008 to 1.172，P=0.031）. The gestational ages at delivery were （35.29 ± 2.25） week in low GWG group，（36.32±1.33） week in recommended GWG group and （36.50±0.94） week in high GWG group respectively，and the differences were statistically significant（P＜0.001）. The multiple logistic regression suggested that the incidences of extreme preterm birth（OR=0.829，95%CI=0.749 to 0.918，P=0.000） and extreme premature rupture of membranes（OR=0.776，95%CI=0.688 to 0.874，P=0.000） were negatively correlated with gestational weight gain，and the differences were of statistical significance. Conclusion：In dichorionic twin pre-gnancies，gestational weight gain conforming to the recommendation of the IOM guideline was beneficial to reduce the incidence of pregnancy complications and to gain favorable perinatal outcomes.