非妊時の体格別にみた妊娠母体の至適体重増加量に関する研究  [in Japanese] A study on appropriate maternal weight gain during pregnancy from a point of body mass index before conception  [in Japanese]

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Author(s)

    • 上田 惠子 UEDA Keiko
    • 奈良県立医科大学産科婦人科学教室 Department of Obstetrics and Gynecology, Nara Medical University School of Medicine
    • 吉田 昭三 YOSHIDA Shozo
    • 奈良県立医科大学産科婦人科学教室 Department of Obstetrics and Gynecology, Nara Medical University School of Medicine

Abstract

妊娠に伴う至適作垂増加量を探るために,非妊娠時の肥満度を指標にした母体体重増加量と母児の予後との関連性をレトロスペクティブに解析した。単胎で正期産分娩の502例(内科的な合併症や帝王切開の既往のある症例は含まれていない。年齢は30.2±4.9歳)を非妊時のBMIにより,やせ群(BMI<18,47例),標準群(18≦BMT≦24,390例),肥満群(BMI>24,65例)の3群に分類し,分娩直前の母体体重増加量,妊娠高血圧症候群や妊娠糖尿病の発症頻度,分娩様式,分娩週数,胎児発育あるいは産褥1ヵ月目の母体体重を調べた。また,各部における妊娠中の体重増加の分布を妊娠中の体重増加量の平均値から,4kg未満,4kg以上8kg未満,8kg以上12kg未満,12kg以上16kg未満,16kg以上の5群に分類し,同様の検討を行った。妊娠に伴う3群間の母体体重増加量には差は認められなかった。しかし,肥満群では体重増加量が8kg以下である症例が多く,また16kg以上の症例も多かった。妊娠高血圧症候群の発症頻度は3群間に差はなかったが,妊娠糖尿病は肥満群だけで認められたことから,非妊時に肥満である母体については厳重な体重管理の必要性が示唆された。一方,やせ群ではLFD児の分娩が,肥満群ではHFD児の分娩の頻度が高かったことから,非妊時に極端なやせや肥満である母体については妊娠経過に応じて詳細に,頻繁に胎児発育をチェックしながら,個々の症例に応じた母体栄養代謝を管理する必要のあることが示唆された。また,極端な体重増加になる母体では産褥後に非妊時の作重に復古できない傾向がみられたので,分娩直前の体重増加が大きい症例については分娩直後から分娩を担当した医療スタッフによる栄養指導と体重管理が必要と思われる。

To clarify the optimal weight gain associated with pregnancy, we retrospectively analyzed the association between maternal weight gain and the outcomes of the mother/child using the degree of obesity prior to pregnancy as a parameter. The subjects were 502 mothers (mean age, 30.2±4.9 years) without medical complications or history of caesarian section who delivered a single full-term infant. The mothers were classified according to the BMI prior to pregnancy into the underweight group (BMK18, 47 mothers), normal weight group (18≦BMI≦24, 390 mothers), and the overweight group (BMI>24, 65 mothers). The maternal weight gain immediately before delivery, the incidences of pregnancy induced hypertention and gestational diabetes mellitus, delivery method, delivery weeks, fetal growth, and maternal body weight 1 month after delivery were evaluated. The weight gain distribution in each group was classified according to the mean weight gain during pregnancy into 5 groups (<4kg, 4kg - <8kg, 8kg - <12kg, 12kg - <16kg, and ≦16kg). No difference was observed in maternal weight gain among the underweight, normal weight, and overweight groups. However, in the overweight group, many mothers showed a weight gain of ≦8kg and also many mothers showing a weight gain of ≦16kg. The incidence of pregnancy induced hypertension did not significantly differ among the 3 groups, but gestational diabetes mellitus was observed only in the overweight group, suggesting the necessity for strict body weight management in obese women prior to pregnancy. The incidence of LFD infants was high in the underweight group, and the incidence of HFD infants was high in the overweight group. Therefore, prior to pregnancy, extremely underweight and overweight women require the management of nutritional metabolism appropriate for each case. In mothers showing extreme weight gain, return to the weight prior to pregnancy was often difficult after delivery. Therefore, in mothers showing marked weight gain immediately before delivery, nutritional guidance and weight management should be performed from immediately after delivery by the medical staff members in charge of delivery.

Journal

  • Japanese journal of maternal health.

    Japanese journal of maternal health. 48(1), 122-131, 2007-04-01

    Japan Society of Maternal Health

References:  11

Cited by:  4

Codes

  • NII Article ID (NAID)
    110006274323
  • NII NACSIS-CAT ID (NCID)
    AN0022863X
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03881512
  • NDL Article ID
    8787321
  • NDL Source Classification
    ZS38(科学技術--医学--産婦人科学) // ZE5(社会・労働--社会問題・社会保障)
  • NDL Call No.
    Z19-1016
  • Data Source
    CJP  CJPref  NDL  NII-ELS 
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