Effects Of Primipara’s BMI During Pregnancy And Serum AFP,β-HCG,uE3Level On Pregnancy Outcomes

Objective To investigate and analyze the effects of primipara’s BM I during pregnancy and Serum AFP, β-HCG, and uE3level on pregnancy outcomes. So as to provide a theoretical basis for the clinical prediction and intervention of the occurrence of certain adverse pregnancy outcomes. And to Provide a basis to explore the appropriate range of weight gain during pregnancy.Methods Primipara single births of Ningxia three tertiary hospitals and a Maternal and Child Health Hospital were tracked and monitored the Prenatal examination,prenatal care card,weight gain during pregnancy, Prenatal maternal serum markers AFP, β-HCG, uE3level(14～20weeks),mode of delivery and birth weight from October2011to October2012. Divided the pregnant woman into three groups according to the BMI during the pregnancy:excess growth group (△BMI≥6,>16kg)、normal growth group(4<△BMI<6,11kg～16kg)、less growth group(△BMI≤4,<11kg).Divided the Prenatal maternal serum markers AFP, β-HCG, uE3level into three groups according the MoM,①AFP level:excess high group(>2.0MoM),normal group(0.5～2.0MoM)and low group(<0.5MoM);②β-HCG level:excess high group(>2.0MoM),normal group(0.5～2.0MoM)and low group(<0.5MoM);③uE3level:normal group (≥0.7MoM), low group (<0.7MoM)。To compare the different BMI growth group between birth weight, mode of delivery, pregnancy complications, childbirth complications.Results1. There were2967primipara Investigated and the final surveyed and information complete were2781. The primipara average age of26.74±1.27years.GiP11125, G2P11398, GsPiand above by258.There were492(17.69%)primipara occurred≥2adverse pregnancy outcomes.There were1082(38.90%)primipara occurred1adverse pregnancy outcomes.The first six adverse pregnancy outcomes of2781primipara were:Cesarean section (31.46%), gestational hypertension (5.03%), neonatal asphyxia (4.96%), LBG (3.73%), fetal distress (3.31%), gestational diabetes mellitus (2.80%)..In the2781Single births newborns, baby boy were1492,(53.64%);baby girl were1289(46.35%).The sex ratio of baby boy and baby girl was1.15:1.LBW67, NBW2610, LBG104, the average birth weight of3429±458kg. Baby boy average birth weight was3465±433g; baby girl average birth weight was3421±429g.2.There was significant difference in the gestational diabetes, gestational hypertension, placental abruption, postpartum hemorrhage, premature rupture of membranes, prolonged second stage, LBG, cesarean section and neonatal asphyxia between excess growth group (△BMI≥6,>16kg), normal growth group(4<△BMI＜6,11～16kg)and less growth group(△BMI≤4,<11kg)(P<0.05)3. AFP level:there were81primipara in excess high group(>2.0MoM),2623primipara in normal group(0.5～2.0MoM)and77primipara in low group(<0.5MoM);β-HCG level:there were79primipara in excess high group(>2.0MoM),2628primipara in normal group (0.5～2.0MoM) and74primipara in low group (<0.5MoM);uE3level:there were2698primipara in normal group (≥0.7MoM),83primipara in low group (<0.7MoM).Determination of serum AFP、β-HCG and uE3value is decreased with increasing of screening weight(r=-0.048,P<0.05; r=-0.044,P<0.05).Determination of serum AFP and uE3value is increased between14-20weeks with the increases of gestational age (P<0.05).4. There was significant difference in the incidence of gestational hypertension,Placental abruption, premature rupture of membranes, fetal distress between Serum AFP,β-HCG’s excess high group(>2.0MoM),uE3’slow group (<0.7MoM) and their normal group(P< 0.05).Serum β-HCG the excess high group’s(>2.0MoM) gestational diabetes incidence is higher than the normal group (P<0.05).The excess high group of serum AFP’s neonatal asphyxia is higher than the normal group (P<0.05)Conclusion1. There were2967primipara Investigated and the final surveyed and information complete were2781. The primipara average age of26.74±1.27years. the average birth weight of3429±458kg. Baby boy average birth weight was3465±433g; baby girl average birth weight was3421±429g.2.excess growth group’s (△BMI≥6,>16kg) gestational hypertension, gestational diabetes, postpartum hemorrhage, placental abruption, premature rupture of membranes, cesarean section, LBG, prolonged second stage of labor, fetal distress, neonatal asphyxia incidence were higher than the normal growth group.The less growth group’s rate of LBW is higher than the other two group (P<0.05)3. There was a relationship between gestational hypertension and cesarean delivery, neonatal asphyxia, the incidence of macrosomia, gestational diabetes excess growth group’s (△BMI≥6,>16kg).4.There was a relationship between gestational hypertension, premature rupture of membranes, placental abruption, fetal distress and Serum AFP,β-HCG’s excess high group(>2.0MoM),uE3’s low group (<0.7MoM)5.This research suggested that mothers best prenatal BMI growth of4～6kg/m2, weight gain during pregnancy in11～16kg, can decrease the incidence of adverse pregnancy outcomes, and weight management in pregnancy is very important to obtain good pregnancy outcomes.