孕前BMI、孕期增重与新生儿异常出生体重关系的两种标准比较摘要[目的] 比较不同分类标准下孕前体质指数、孕期增重与新生儿出生结局的关系，为制定孕期体重管理方案提供科学依据。
[方法] 问卷调查并结合医院病历系统收集627例单胎孕产妇及其新生儿数据，根据WHO及中国BMI划分标准将孕产妇分为体重过轻组、正常组、超重肥胖组。
采用美国IOM （2009）标准对孕期增重进行划分和评价。
比较WHO和中国标准下，孕妇体重、孕期增重的分布及各组巨大儿、低体重儿发生率。
[结果] 两标准下孕前BMI及孕期增重情况的分布差异均有统计学意义（p<0.001），中国标准下孕前超重肥胖者、孕期增重过多者比例均较高。
孕前超重肥胖组和孕期增重过多组巨大儿的出生率均最高，但中国标准（15.3%，11.4%）均高于WHO标准（10.3%，9.3%），差异有统计学意义（p=0.003，0.03），且中国标准下，组间差异均有统计学意义（p<0.001，p=0.035）而WHO 标准下，组间差异不明显（p=0.073，0.424）。
两标准下孕期增重不足组低体重儿出生率均最高，且组间差异均有统计学意义（p=0.006，0.003），而两标准间差异无统计学意义（中国5.8%，WHO 5.9%）。
[结论] 中国BMI分类标准对于保障中国妇幼健康可能更有指导意义，但尚需更大样本的研究。
关键词：标准；孕前BMI；孕期增重；新生儿体重Comparison of Relationships between pre Pregnancy BMI, Weight Gain during Pregnancy and Abnormal Birth Weight in Neonates under Two CriteriaAbstract Objective: The relationship between pre-pregnancy body mass index（BMI）, gestational weight gain and neonatal birth outcome were compared under different classification criteria, so as to provide scientific basis for the formulation of pregnancy weight management. Methods: Data of627 single pregnant women and their newborns were collected by questionnaire survey and hospital medical record system. Pregnant women were divided into overweight group, normal group and overweight obesity group according to BMI classification standard of WHO and China. The American IOM (2009) standard was used to divide and evaluate the weight gain during pregnancy. To compare the distribution of pregnant women's pre-pregnancy weight, weight gain during pregnancy and the incidence of macrosomia and low birth weight infants in different groups of pregnant women under WHO and China standards.Results：There were significant differences in BMI before pregnancy and weight gain during pregnancy between the two criteria (p < 0.001).Under the Chinese standard, the proportion of overweight and obese pregnant women and those with excessive weight gain during pregnancy were higher.Pre-pregnancy obesity and overweight group had the highest birth rate of macrosomia, the rate was statistically higher under Chinese standard (15.3%, 11.4%) than that under WHO (10.3%, 9.3%，p = 0.003, 0.03). Under the Chinese standard, there was a significant difference between the groups (p < 0.001, P = 0.035),,but the difference was not significant under the WHO standard (p = 0.073, 0.424).Under the two criteria, the birth rate of low birth weight infants in the group with insufficient weight gain during pregnancy was the highest, and the differences between groups were both statistically significant (p = 0.006, 0.003). There was no significant difference between the two standards (5.8% in China, 5.9% in WHO.). China's BMI classification criteria may be more instructive for the protection of maternal and child health in China, but more sample studies are needed.Key words:Standard; pre pregnancy BMI; weight gain during pregnancy; neonatal weight我国人群超重肥胖患病率逐年升高，《中国居民营养与慢性病状况报告（2015）》指出全国18岁及以上成人超重率为30.1%，肥胖率为11.9%。
