BMI別にみた妊娠中および産褥1ヵ月の母体体重の変化  [in Japanese] Gestational weight gain and the 1-month postpartum weight retention stratified by prepregnancy body mass index  [in Japanese]

正常な母体の妊娠中と産褥1ヵ月での体重変化およびそれに影響を及ぼす要因を明らかにすることを目的に調査を行った。K県内の総合病院で, 2002年1〜12月に正期産, 単胎の分娩1,012例から, 帝王切開術症例や記録不備を除く626例(初産婦342例, 経産婦284例)を対象とし, カルテよりデータを抽出した。妊娠前BMIが18.0未満を「やせ」, 18.0〜24.0未満を「標準」, 24.0以上を「肥満」とした。妊娠前BMI別に妊娠中から産褥1ヵ月までの体重の変化を比較検討し, その関連要因について分析した。妊娠中の体重増加量(平均kg±SD)は, 「やせ」群(10.6±3.6)や「標準」群(9.6±3.3)に比べて, 「肥満」群(8.2±4.4)が少なく(p<0.01), 逆に産後1ヵ月までの体重減少量は, 「肥満」群(7.7±2.4)が「やせ」群(6.9±2.2)や「標準」群(7.0±2.0)よりも多かった(p<0. 05)。すなわち, 妊娠前BMIが高いほど, 妊娠中の体重増加が少なく, 産後の体重減少量が多い結果であった。妊娠中の体重増加量や児の出生体重, 妊娠前BMIが多いと, 産褥1ヵ月での体重減少は大きく, 出産回数が増すと, 体重減少は少ないことが明らかとなった。

This study was conducted to observe the changes in maternal body weight of normal women during pregnancy and one month following delivery and to elucidate the factors that may affect such changes. From the 1,012 women who had term delivery of singletons in a general hospital in Prefecture K between January and December 2002, those who had undergone a cesarean section or lacked complete medical records were excluded and the data from the medical records for the remaining 626 mothers (342 nulliparous and 284 multiparous women) were selected for our study. Their somatotypes were stratifred as "underweight" for those with a BMI below 18.0 before pregnancy ; "normal weight" for 18.0 to 24.0 and "overweight" for over 24.0 Also based on the BMI before pregnancy, the changes in body weight during pregnancy and one month after delivery were compared and factors related to such changes were analyzed. Compared with the "underweight" (10.6±3.6) or "normal weight" (9.6±3.3) group, the weight gain during pregnancy of the "overweight" group (8.2±4.4) was modest (p<0.01), while the weight loss (7.7±2.4) of the same group within one month of delivery was greater (p<0.05) than the others (the "underweight" group, 6.9±2.2 and the "normal weight" group, 7.0±2.0). It was concluded that the greater the pre-pregnancy BMI, the smaller the weight gain during pregnancy and the greater the weight loss after delivery. It became apparent that the greater gain during pregnancy, birth weight, and pre-pregnancy BMI are associated with a greater weight loss one month after delivery. It was also found that increases in parity coincide with a less obvious weight loss.