孕早期孕妇体成分及相关因素对巨大儿的影响及预测价值OA

Objective To study the influence and predictive value of maternal body composition and related factors in early pregnancy on macrosomia.Methods A retrospective study was conducted,which included 953 pregnant women who established antenatal care records and underwent body composition measurement in early pregnancy in Suzhou Municipal Hospital from December 2019 to June 2020.Based on neonatal birth weight,the pregnant women were divided into the macrosomia group(with birth weight≥4 000 g,n=54)and the normal group(with birth weight 2 500-4 000 g,n=899).General clinical data of the subjects were collected,including maternal age,height,pre-pregnancy body mass index(BMI),gestational weight gain,obstetric history,gestational age at delivery and history of gestational diabetes mellitus(GDM),and body composition measurements in early pregnancy,and neonatal birth weight and gender.The general clinical data and body composition indicators were compared between the two groups of pregnant women.Multivariate Logistic regression analysis was performed to identify the independent risk factors for macrosomia,and receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of body composition indicators for macrosomia.Statistical analysis was performed using the independent samples t-test and χ2 test.Results The maternal height,pre-pregnancy BMI,gestational weight gain,and gestational week at delivery in the macrosomia group were significantly higher than those in the normal group[(164.94±4.10)cm vs(162.39±4.73)cm,(22.44±2.56)kg/㎡ vs(20.96±2.82)kg/㎡,(16.32±6.43)kg vs(13.44±4.63)kg,and(39.92±0.91)weeks vs(39.15±1.28)weeks,respectively;t values were-3.888,-4.110,-4.326,-4.437;all P<0.001].Furthermore,all body composition related indicators of pregnant women except of total body water percentage in the macrosomia group were also significantly higher than those in the normal group(all P<0.001).The incidence of macrosomia in male newborns was significantly higher than that in female newborns.Multivariate Logistic regression analysis revealed that gestational weight gain(OR=1.112,95%CI:1.047-1.180),total body water(OR=1.680,95%CI:1.230-2.290)and body fat percentage(OR=1.816,95%CI:1.211-2.724)were independent risk factors for macrosomia(all P<0.05).ROC curve analysis further revealed that the area under the curve(AUC)for predicting macrosomia using total body water,body fat percentage,and their combination were 0.672,0.649,and 0.719,respectively(all P<0.05).Conclusion Total body water and body fat percentage in early pregnancy serve as independent risk factors for macrosomia,offering potential early predictive indicators with reference value for nutritional guidance and weight management during pregnancy.