摘要：目的探讨孕妇营养认知行情况与孕期体重增长、分娩前血脂情况及分娩方式、新生儿出生体重的关系,为营养干预治疗提供临床资料。方法 2011年9~12月在我院产科住院分娩孕妇180例,参考孕妇营养知识、态度及行为(K-A-P)模式并结合本研究调查目的,进行问卷设计及评分分组。分析孕妇营养认知行对孕期体重增长、甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)水平及分娩方式、新生儿出生体重的影响。结果高、中评分组孕期体重增长、TG和TC水平、新生儿出生体重均低于低评分组,差异均有统计学意义(F=21.787、21.171、23.412、12.160,P均0.05);高评分组剖宫产率低于中评分组(χ2=1.220,P0.05)。结论提高孕妇的营养认知行水平,控制孕期体重和TG、TC水平,使新生儿出生体重在正常范围,可降低剖宫产率。

摘要：Objective: To evaluate the association between maternal body mass index and obstetrical outcome in patients with a prior cesarean undergoing a trial of labor versus elective repeat cesarean. Study design: A perinatal database between 1991 and 1997 was used to identify secundipara at term after a previous cesarean section. In different groups according to maternal body mass index, the rates of successful vaginal birth after caesarean, uterine scar separation, and other obstetrical outcomes were evaluated. Results: Of 8580 patients with a prior cesarean, 1862 (21.7%) underwent an elective repeat cesarean and 6718 (78.3%) underwent a trial of labor. Maternal body mass index correlated inversely with the rate of successful vaginal birth after caesarean but not with the rate of uterine scar separation. After adjustment for confounding factors including maternal age, birth weight, induction of labor, and preeclampsia, maternal body mass index remained associated with a lower rate of successful vaginal birth after cesarean. Conclusion: Maternal body mass index is an independent factor associated with a lower rate of successful vaginal birth after cesarean.

摘要：Objective: The purpose of this study was to evaluate the relationship between prepregnancy maternal body mass index and spontaneous preterm birth and indicated preterm birth. Study design: This was a secondary analysis of the Maternal- Fetal Medicine Units Network, Preterm Prediction study. Patients were classified into categories that were based on their body mass index. Rates of indicated and spontaneous preterm birth were compared. Results: Five hundred ninety- seven (20.5% ) of 2910 women were obese. Obese women had fewer spontaneous preterm births at < 37 weeks of gestation (6.2% vs 11.2% ; P <. 001) and at < 34 weeks of gestation (1.5% vs 3.5% ; P =. 012). Women with a body mass index of < 19 kg/m2 had 16.6% spontaneous preterm birth, with a body mass index of 19 to 24.9 kg/m2 had 11.3% spontaneous preterm birth, with a body mass index of 25 to 29.9 kg/m2 had 8.1% spontaneous preterm birth, with a body mass index of 30 to 34.9 kg/m2 had 7.1% spontaneous preterm birth, and with a body mass index of ≥ 35 kg/m2 had 5.2% spontaneous eterm birth (P <. 0001). Indicated delivery was responsible for an increasing proportion of preterm births with increasing body mass index (P =. 001). Obese women had lower rates of cervical length < 25 mm (5% vs 8% pr.; P =. 012). Multivariable regression analysis confirmed a lower rate of spontaneous preterm birth in obese gravid women (odds ratio, 0.57; 95% CI, 0.39- 0.83; P =. 003). Conclusion: Obesity before pregnancy is associated with a lower rate of spontaneous preterm birth.