中文摘要：

目的通过对分娩巨大儿及非巨大儿产妇的多项临床资料分析比较,探讨产生巨大儿的危险因素,为实施早期干预,减少巨大儿的发生风险提供依据。方法选取2014年1月至2015年10月在湖北省妇幼保健院按期产检及分娩的产妇1 793例,对孕妇孕期体重增长等体检指标、妊娠期并发症及新生儿出生结局进行跟踪观察,结合孕前体质指数（BMI）、采用单因素分析和Logistic多因素回归分析方法,分析影响巨大儿发生的危险因素。结果按孕前BMI分组,1 793名孕妇中孕前消瘦者占19.4%,体重正常者占74.3%,超重肥胖者占6.3%。孕期增重低于美国国家科学院（IOM）推荐标准者占16.1%,符合IOM推荐标准者占39.9%,高于IOM推荐标准者占44.0%。妊娠糖尿病发生率9.6%,分娩巨大儿占6.9%。孕前超重肥胖者分娩巨大儿的风险是孕前体重正常者的2.09倍,孕期增重高于IOM推荐标准者分娩巨大儿的风险是符合标准者的2.92倍,男婴为巨大儿的风险是女婴的3.12倍。结论孕前BMI、孕期增重、新生儿性别是发生巨大儿的独立危险因素。控制孕前BMI及孕期增重能有效降低巨大儿的发生率。

英文摘要：

Objective To analyze the risk factors of fetal macrosomia and provide the basis for the early intervention to reduce the risk of macrosomia Methods From January 2014 to December 2015,a total of 1 793 cases of pregnant women and their newborns were recruited from a cohort study in Hubei Maternal and Child Health Hospital Clinical data of maternal age,parity,disease history,gestational diabetes mellitus（GDM）,dietary habit,neonatal gender,pre-pregnancy body mass index（BMI） and gestational weight gain were collected.Associations between exposure risk factors and macrosomia were analyzed using chrsquared test Logistic regression models were used to assess the independent association between these potential predictors and macrosomia Results Among the 1 793 subjects,19.4%women were underweight,74.3%had normal BMI,and 6.3%were classified as overweight or obesity according to their pre-pregnancy BML Gestational weight gain of 16.1%women was less than,39.9%were within and 44 0%were more than IOM recommended standard.The prevalence of GDM was 9.6%and the fetal macrosomia accounted for 6.9%in all neonates.Women who gained more than IOM guidelines for weight gain had a higher risk（RR=2.92）of delivering fetal macrosomia when compared with women who gained within the IOM recommended standard It was more possibile（RR=2.09） for the progestational overweight or obese women to deliver a macrosomia compared with the women with progestational normal weight The prevalence of male macrosomia was 3.12 times that of female macrosomia Conclusion Pre-pregnancy BMI,gestational weight gain and neonatal gender are independent risk factors for fetal macrosomia Control of pre-gravid BMI and gestational weight gain can effectively reduce the risk of macrosomia.