임신 전 체질량지수와 임신 중 체중 증가에 따른 주산기 예후
Perinatal outcomes associated with prepregnancy body mass index and weight gain during pregnancy
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목적: 임신 전 체질량지수와 임신 중 체중 증가에 따른 주산기 예후와의 관련성에 대하여 알아보고자 하였다. 연구 방법: 2005년 1월부터 2007년 12월까지 본원에서 만삭 분만하였던 임신부 중에서 임신 전 체질량지수를 알 수 있었던 임신부를 대상으로 하여 체질량지수(body mass index [BMI], kg/m2)는 아시아 기준 저체중(<18.5), 정상체중(18.5≤BMI<23), 과체중(23≤BMI<25), 비만(≥25)의 네 군으로 나누어 비교하였으며, 임신 중 체중 증가는 정상 체중 증가를 12~13.5 kg을 기준으로 저체중 증가군(<12 kg), 정상 체중 증가군(12~13.5 kg), 과체중 증가군(>13.5 kg)의 세 군으로 나누어 비교하였다. 각 군에서의 모성합병증과 신생아합병증 유무를 조사하였다. 결과: 연구 대상 임신부는 전체 225명이었고, 임신 전 체질량지수에 따라 나누었을 때 각각 저체중군 35명(15.5%), 정상체중군 132명(58.7%), 과체중군 31명(13.8%), 비만군 27명(12.0%)이었으며. 임신 중 체중 증가는 저체중 증가군 73명(32.4%), 정상 체중 증가군 44명(19.6%), 과체중 증가군 108명(48.0%)이었다. 임신 중 체중 증가의 정도를 세 군으로 나누어 임신 전 체질량지수에 따른 분포와 비교하여 보면 통계적으로 의의 있게 저체중군에서 과체중 증가군이 많았으며, 과체중군, 비만군에서 저체중 증가군이 많았다. 주산기 예후에서는 임신 전 체질량지수가 높을수록 임신성 당뇨, 제왕절개분만의 빈도, 거대아의 빈도가 각각 의의 있게 높았다. 그리고 임신 중 체중 증가가 많을수록 제왕절개분만의 빈도, 거대아의 빈도에서 각각 의의 있게 높았다. 결론: 임신 전 체질량지수가 높을수록 임신성 당뇨, 제왕절개분만, 거대아가 의의 있게 증가하였으며, 임신 중 체중 증가가 많을수록 제왕절개분만, 거대아가 의의 있게 증가하였다.
Abstract
Objective: To examine the association between prepregnancy body mass index (BMI), gestational weight gain and perinatal outcomes. Methods: The data of women who delivered at term in our institute from January 2005 to December 2007 were analyzed retrospectively. Four categories of prepregnancy BMI and three categories of gestational weight gain were constructed and used maternal, neonatal outcomes. Results: This study included 225 women with term delivered in our institute. According to prepregnancy BMI categories, lean (<18.5), normal (18.5≤BMI<23), overweigh (23≤BMI<25), obese (≥25) were 35, 132, 31, 27, respectively. According to gestational weight gain categories, lean (<12 kg), normal (12~13.5 kg), overweight (>13.5 kg) were 73, 44, 108, respectively. Gestational weight gain above guidelines was common in low prepregnancy weight group, this difference was statistically significant. In women with increased prepregnancy BMI was associated with increased risk of gestational diabetes mellitus, cesarean section rate, and large for gestational age (LGA) (P<0.05). In women with overweight gain during pregnancy was associated with increased cesarean section rate and LGA (P<0.05). Conclusion: Increased prepregnancy BMI was associated with increased gestational diabetes mellitus, cesarean section rate, and LGA. Also excessive weight gain during pregnancy was associated with increased cesarean section rate and LGA.
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