双胎妊娠孕前体重指数和孕期体重增加与母婴结局关联性探究

An Investigation into Correlation Analysis of Pre-Pregnancy BMI and Gestational Weight Gain on Maternal-Neonatal Outcomes in Twin Gestations

摘要: 目的：ppBMI和GWG对妊娠结局的调控作用始终是围产医学研究的核心命题，本研究将对双胎妊娠孕妇的ppBMI与GWG对母婴结局的影响进行探究，并同时探究ppBMI和GWG对母婴结局的影响关联性。方法：采用回顾性研究分析的方法，选取2020年1月至2024年12月孕早期于河南省人民医院围产保健科建档，并于我院进行分娩的双胎孕妇为研究对象。按照计算所得ppBMI将参与者进行分组，通过IOM推荐的每周GWG按照公式计算平均每周GWG，将每组ppBMI类别根据其分界点进行分层。统计出每组ppBMI类别及每个平均每周GWG区间与母婴结局的关系，并分析ppBMI和GWG对母婴结局的综合影响。结果：在妊娠期并发症中，高ppBMI的GWG不足使GDM、PROM的风险更高，高ppBMI的GWG过多使HDP、剖宫产的风险更高；在新生儿结局中，低ppBMI的GWG不足使SGA的风险更高，高ppBMI的GWG不足使PTB、低APGAR评分的风险更高，高ppBMI的GWG过多使NICU入住率的风险更高。结论：GWG不足的双胎孕妇对母婴不良结局的关联性更大，尤其是低ppBMI的孕妇。

Abstract: Objective: The regulatory effects of ppBMI and GWG on pregnancy outcomes have always been the core proposition of perinatal medicine research. This study will explore the effects of ppBMI and GWG on maternal-neonatal outcomes in pregnant women with twin gestations, and explore the correlation between ppBMI and GWG on maternal-neonatal outcomes. Methods: A retrospective study was conducted to select twin pregnant women who were registered in the Perinatal Health Care Department of Henan Provincial People’s Hospital from January 2020 to December 2024 and gave birth in our hospital during the first trimester. Participants were grouped according to the calculated ppBMI. The average weekly GWG was calculated according to the formula using the IOM recommended weekly GWG, and each group of ppBMI categories was stratified according to its cut-off point. The relationship between ppBMI category of each group and the average weekly GWG interval and maternal-neonatal outcomes was analyzed, and the combined effects of ppBMI and GWG on maternal-neonatal outcomes were analyzed. Results: In pregnancy complications, GWG with high ppBMI was associated with a higher risk of GDM and PROM, while GWG with high ppBMI was associated with a higher risk of HDP and cesarean section. In neonatal outcomes, GWG deficiency with low ppBMI was associated with a higher risk of SGA, GWG deficiency with high ppBMI was associated with a higher risk of PTB, low APGAR score, and excessive GWG with high ppBMI was associated with a higher risk of NICU occupancy. Conclusion: Twin-born women with GWG deficiency are more associated with adverse maternal and infant outcomes, especially those with low ppBMI.