| 摘要: | 背景及目的：孕婦健康狀況與新生兒健康狀況是密切相關的，許多文獻指出，若孕婦身體質量指數（BMI）過高或體重過重，除了會影響母體本身健康狀況外，也會影響新生兒之健康。但由於孕婦會有顯著的體重上升，過去並沒有相關的研究，用以探討孕前孕婦BMI的最佳值。因此本研究利用孕婦最後一次產檢之身高、體重換算成BMI，將妊娠前母親BMI與新生兒健康指標作統計分析，希望可以找出其相關性，做為未來孕婦控制體重的建議。研究方法：本研究查閱南部某醫學中心之院內病歷系統資料庫，收案對象為民國102年於院內出生之所有新生兒，排除限制條件並進行重新編碼後，分別記錄新生兒之第一分鐘及第五分鐘Apgar Score、出生體重、身高、頭圍、胸圍及腹圍等新生兒健康指標，以及其母親生產前最後一次身高體重、懷孕週數，以統計方法，探討孕婦BMI與新生兒健康指標之相關性。研究結果：本研究共收集1462為新生兒，孕婦最後一次BMI平均為27.12±3.82kg/m2；平均懷孕週數為38.57±1.84週；新生兒出生體重為3031±453公克。孕婦BMI與其懷孕次數、生產次數及流產次數皆呈顯著正相關；與新生兒之Apgar Score第一分鐘呈顯著負相關；體重、頭圍、胸圍及腹圍皆呈顯著正相關；而將孕婦分別依有無疾病、不同生產方式、年齡及教育程度高低分組，不同組別間之BMI皆有顯著差異；使用曲線迴歸模型發現，孕婦每增加或減少一個BMI，Apgar Score第一分鐘分數會減少0.162分；Apgar Score第五分鐘分數會減少0.195分。以上結果表示，妊娠前母親BMI過高或過低，均會造成新生兒身體健康不良影響。
BackgroundThe nutritional status of pregnant women influences neonatal health. Both women with obesity and poor gestational weight gain are at increased risk of having complications at delivery, giving birth to small for gestational age and preterm birth. Although there are guidelines suggesting proper gestational weight gain, no study has found out the best maternal body mass index （BMI） just before labor. The aim of this study was to determine the association between the maternal BMI before labor and neonatal health status, and try to find out the best maternal BMI before labor as a suggestion for body weight control during pregnancy.Materials and Methods The study subjects were pregnant women who were admitted to a medical center of Taiwan for giving birth to their babies between 2013/01/01 and 2013/12/31. Neonatal data were collected including birth body weight（BBW）, height, head circumference, chest circumference, abdominal circumference, Apgar score at 1 and 5 minutes. We also collected labor characteristics such as gestational age（GA）, types of delivery, and the last maternal BMI measured before labor. We used multivariable regression models to study the association of maternal BMI before labor and neonatal outcomes.Results 1462 pregnant women and their newborns were recruited. The average of the last maternal BMI before labor was 27.12 ± 3.82 kg/m2. The average of GA was 38week+4days ± 1.84 weeks. The average of BBW was 3031± 453 g. There were positive correlations between maternal BMI and BBW, head circumference, chest circumference, and abdominal circumference. Pregnant women were devided into groups according to their age, education level, different types of delivery, and had diseases or not. The maternal BMI of all these groups had significant difference. Quadratic regression analysis showed that maternal BMI square was closely associated with both Apgar score at 1 and 5 minutes （both P<0.001）. When the last maternal BMI before labor increasing or decreasing 1 kg/m2, Apgar score at 1 and 5 minutes will drop 0.162 and 0.195 points respectively. As a result, both too high or too low of the last maternal BMI before labor increase the risk of poor health of newborn. |
