丁小莉,陈兰,钟燕
DING Xiaoli,CHEN Lan,ZHONG Yan

• 1:德阳市人民医院

摘要(Abstract)：

目的:探讨初产妇孕期体质指数(BMI)变化及孕中期母体血清甲胎蛋白(AFP)、β-人绒毛膜促性腺激素(β-HCG)、游离雌三醇(u E3)水平对妊娠结局的影响。方法:收集513例产前检查并顺利分娩的初产孕妇及新生儿资料,记录孕妇孕期BMI值、孕期检查情况及并发症、分娩方式以及妊娠结局,记录新生儿出生体重,检测孕妇(孕14~20周)空腹静脉血清AFP、uE3、β-HCG水平,观察初产妇孕期BMI及血清娠AFP、u E3、β-HCG水平与不良妊娠结局的相关性。结果:孕期BMI增长过多与剖宫产、妊娠期高血压、巨大儿、新生儿窒息、妊娠期糖尿病均呈正相关(χ~2=17.170、17.110、17.318、12.870、10.835,P<0.05),血清AFP>2.0 Mo M与胎盘早剥、胎膜早破、胎儿窘迫、妊娠期高血压均呈正相关(r=0.458、0.362、0.735、0.466,P<0.05),β-HCG>2.0 Mo M与胎盘早剥、胎膜早破、妊娠期高血压、胎儿窘迫、妊娠期糖尿病均呈正相关(r=0.202、0.218、0.368、1.000、0.488,P<0.05),u E3<0.7 Mo M与妊娠期高血压、胎儿窘迫、胎膜早破、胎盘早剥均呈正相关(r=0.490、0.712、0.754、0.684,P<0.05)。结论:初产妇孕期BMI值增加过多,以及孕中期AFP、β-HCG水平过高和u E3水平过低会增加不良妊娠结局风险。
Objective: To investigate the effect of BMI during pregnancy,serum AFP,β-HCG,uE3 levels during second trimester of primipara on adverse pregnancy outcomes. Methods: The data of 513 pregnant women who received prenatal examination and delivery were collected,and the BMI value of pregnant women during pregnancy,pregnancy examination,complications,delivery mode and pregnancy outcome were recorded; the neonatal birth weight was recorded and the fasting serum AFP,uE3,beta-HCG levels were detected for pregnant women at 14 ~ 20 weeks and observe their correlation with adverse pregnancy outcomes. Results: There was a positive correlation between the BMI excessive growth during pregnancy with cesarean section,hypertension during pregnancy,macrosomia,neonatal asphyxia and gestational diabetes mellitus( χ~2= 17. 170,17. 110,17. 318,12. 870,10. 835,P < 0. 05).Serum AFP > 2. 0 Mo M with placental abruption,premature rupture of membranes,fetal distress,gestational hypertension were positively correlated( r = 0. 458,0. 362,0. 735,0. 466,P < 0. 05). β-HCG> 2. 0 MoM with placental abruption,premature rupture of membranes,pregnancy-induced hypertension,fetal distress,pregnancy-induced hypertension were positively correlated( r = 0. 202,0. 218,0. 368,1. 000,0. 488,P < 0. 05). There was a positive correlation between u E3 < 0. 7 MoM with gestational hypertension,fetal distress,premature rupture of membranes and placental abruption,(r=0.490、0.712、0.754、0.684,P<0.05).Conclusion:BMI excessive growth during pregnancy and high levels of AFP,β-HCG and low levels of uE3 in the second trimester increase will increase the risk of adverse pregnancy outcome of primipara.

关键词(KeyWords)： 妊娠结局;人体质量指数;甲胎蛋白;绒毛膜促性腺素;雌三醇
pregnancy outcome;body mass index;alpha-fetoprotein;chorionic gonadotropin;estriol

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 丁小莉,陈兰,钟燕
DING Xiaoli,CHEN Lan,ZHONG Yan

DOI: 10.19367/j.cnki.1000-2707.2017.04.026

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