| Objective:1.In order to administer and direct pregnant women reasonably, we probe into the relationship between individual nutrition supply in pregnancy and the control of the maternal weight and the decrease of the macrosomia.In this way,the excessive weight increase during pregnancy will be controlled,the incidence of macrosomia will be reduced and the complications in pregnancy will be decreased.2.In order to make pregnancy nutrition guide directly,the risk factors which affect maternal weigh and macrosomia are analysed.Methods:203 women were selected as the research group who have their prenatal examination and delivered in Jinan Women and Children Healthy Hospital from June of 2006 to June of 2007.Another 257 women were selected as the control group who have their prenatal examination and delivered in the same hospital.According to the BMI of progestation or the BMI before 12-week pregnancy we divided them into three groups of normal weight(BMI 18.5～22.9),overweight(BMI 23～24.9) and obesities(BMI≥25).Nutrition that pregnant women of the research group need,absorb,lack and overfeed was analyzed by the software of Pregnancy Nutrition expert Monitoring(PNM1.0). These three study groups were supplied different energy of 36～40,33～36, 30～33Kcal/kg/day.A method combining food exchange list with glucose index was used to direct the control and selection of total calorie intake and food.At the same time the software of Pregnancy Nutrition expert Monitoring was utilized to regulate the supply of the heat energy and various kinds of nutrition. The pregnant women in research group performed light physical labor.But heat energy supply to the control group is without restriction.Results:1.The weight gain during pregnancy,BMI increased,birth weight of the research group were all lower than that of the control group and the consequential discrepancy was significant(P＜0.01).2.The GDM and the cephalopelvic disproportion both indicated significant difference between the two groups(P＜0.05).The macrosomia in the normal weight and overweight indicated significant difference between the study group and the control group (P＜0.05).But no significant difference was shown in obesities between two the groups(P＞0.05).3.The logistic regression analysis of pregnancy BMI increase showed that the risk factors were ante partum BMI(OR=6.37),ante partum weight(OR=3.55),GDM(OR=1.36),newborn birth weight(OR=1.34), preeclampsia(OR=1.32),progestation BMI(OR=0.16,β=-1.86),.progestation weight(OR=0.6,β=-0.51).4.The logistic regression analysis of macrosomia showed that the risk factors were gestational BMI increase(OR=1.58), gestational weight gain(OR=1.52),GDM(OR=1.50),ante partum BMI(OR=1.50), progestation BMI(OR=1.36),ante partum weight(OR=1.32),age(OR=1.27), progestation weight(OR=1.01).Conclusion:1.The feasible clinical effect on controlling gestational weight gain,reducing newborn birth weight and decreasing the incidence rate of macrosomia and GDM is achieved by means of giving diverse energy supply according to the different pregnant women who have different BMI.Accordingly, the rate of cesarean section caused by cephalopelvic disproportion will be reduced.2.Gestational weight gain and BMI increase are the main risk factors for ante partum weight increase,macrosomia and perinatal complications.So we should strengthen the reasonable control of gestational weight and attach importance to the reasonable control of the progestation weight and active treatment for perinatal complications. |
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