孕產婦體重管理之效果

Effect of Bodyweight Control in Pregnancy

張永生(Yong-Sheng Chang) ； 黃禮偉(Li-Wei Huang) ； 江千代(Chien-Dai Chiang) ； 林妙卿(Miao-Ching Lin) ； 邵文逸(Wen-Yi Shau)

《北市醫學雜誌》 3卷4期 (2006/04) Pp. 373-384

https://doi.org/10.6200/TCMJ.2006.3.4.08

摘要

目的：孕婦的體重與母親和胎兒的健康有很大的關係。體重過重的孕婦常會增加母親生產的危險性，對胎兒也未必有利。臺灣地區的孕婦體重在最近十年來有增加的趨勢，本研究的目的即在設計一套孕婦的產前衛教模式，看是否能經由正確的營養學衛教與產前運動，來達到有效控制孕產婦體重的目的。方法：將在本院產檢之孕婦依意願分為實驗組（衛教組）與對照組，實驗組在妊娠早期請專家施以營養學與體適能活動的指導課程，讓孕婦儘可能早期熟悉基本營養學知識，與如何做適當的產前運動。對照組則完全依一般孕婦產檢方式，不另施以教育與產前運動訓練。依不同生育年齡層，分為四組，A組：20~24歲，B組：25~29歲，C組：30~34歲，D組：35歲以上。比較四組中衛教組與對照組生產時之母親體重與生產併發症，結果作科學之統計與分析。結果：衛教組與對照組的各年齡層中，包括年齡、孕前體重、孕前BMI、懷孕週數、新生兒體重與產科併發症，均沒有達到統計學上的顯著差異。但在妊期增加體重與BMI值兩項上，衛教組與控制組達到統計學上之差異。衛教組比無衛教組在妊期體重的平均值少0.925公斤，其差異的95%信賴區間為(-1.837, -0.014)，P value=0.047。衛教組增加之BMI值也比無衛教組少0.392(kg/平方公尺)，其差異的95%信賴區間為(-0.754, -0.030)，P value=0.047。結論：由此項「孕產婦體重管理計畫」的研究中可發現：孕婦若在妊娠初期即施以營養學的指導或教以適當的產前運動，確實有助於孕婦的體重控制。在此項研究中，雖然實驗組的孕婦體重增加值比對照組少，但無論在產科併發症或新生兒體重上卻看不出統計學上的差異。此部份可能需要更多的個案數或多中心連合研究，方能有更可信賴的結論。

關鍵字

孕婦體重 ； 新生兒體重 ； 身體質量指數 ； 產科併發症

並列摘要

Background and Purpose: The bodyweight of pregnant women affects maternal and fetal health very much. Overweight is a risk factor of delivery and not good for fetus. During last 10 years, the body weight of pregnant women in Taiwan becomes more and more. The purpose of this study is to design a program for pregnant women. The program shows a model of education and physical practice for pregnant women. By means of proper dietetic course and antenatal physical exercise training course, we can effectively control the bodyweight of pregnant women in a reasonable range. Methods: We divided enrolled pregnant women at our hospital in two groups: study group and control group. Study group accepted dietetic lecture course and physical exercise training course. Control group accepted routine antenatal care on schedule only. Each group divided into 4 subgroups depending on maternal age: Gr. A: 20~24, Gr. B: 25~29, Gr. C: 30~34, Gr. D:＞35. We compared 4 subgroups in each and analyzed the results after giving birth. Results: There is no significant difference between study group and control group in maternal age. The enrolled bodyweight and BMI, gestational age, bodyweight of newborn and obstetric complications. But the bodyweight gain in study group is less than control group by 0.925kg, the 95%Cl ( confident interval) is (-1.837, -0.014), P value 0.047. The value of BMI (body mass Index) in study group is also less than control group by 0.392(kg/m^2), Cl is (-0.754, -0.030), p value 0.047. Conclusion: This study reveals that dietetic and antenatal exercise courses at early gestational stage are effective to control the bodyweight of pregnant women. Although the average bodyweight of study group is less than that of control group, obstetric complications and the average body weight of newborn seem no difference between two groups. This part needs more cases or multi-center study. There will be leading to a more reliable result.

並列關鍵字

bodyweight of pregnant women ； bodyweight of newborn ； BMI body mass Index ； Obstetric complications