关键词: 巨大胎儿, 孕妇, 体重增长, 膳食, 影响因素分析

Abstract: Background　In recent years，with the extensive development and active intervention of screening for gestational diabetes mellitus，the incidence of diabetic macrosomia has gradually decreased.However，the proportion of macrosomia in pregnant women with normal glucose metabolism has increased year by year.Objective　To explore the incidence of non-diabetic fetal macrosomia （NDFMS） and its influencing factors，and to provide relevant evidence for community interventions.Methods　From January 2016 to June 2017，maternity patients who were hospitalized in the Obstetrics and Gynecology Department of Daxing Teaching Hospital of Capital Medical University and the birth weight of whose newborn baby was more than 4 000 g were selected，and 186 women who were excluded from pregnancy with diabetes were selected as the NDFMS group.And 197 women who gave birth to newborns with normal birth weight during the same period were randomly selected as the normal group.General data of maternity women and their spouses，and diet data during pregnancy and exercise-related data were collected in the form of face-to-face interviews within 5 days after delivery.Multivariate Logistic regression was used to analyze the influencing factors of NDFMS.Results　The total delivery volume was 9 942 cases，and 785 cases were fetal macrosomia，including 114 cases of diabetic fetal macrosomia and 671 cases of NDFMS.The incidence rate of diabetic fetal macrosomia was 9.77% （114/1 167），and the incidence rate of NDFMS was 7.65% （671/8 775）．The difference was statistically significant （χ2=6.377，P=0.012）．The proportion of primipara，maternal height，gestational weight gain，spouses' height，daily average staple food intake，daily average sugar intake，and daily average fruit intake in the NDFMS group were higher than those of women in the normal group （P<0.05）．Multivariate Logistic regression analysis showed that the parity 〔OR=0.556，95%CI（0.363，0.882）〕，maternal height 〔OR=1.126，95%CI（1.074，1.181）〕，gestational weight gain 〔OR=1.030，95%CI（1.004，1.056）〕，daily average fruit intake 〔OR=0.998，95%CI（0.997，0.999）〕 was the independent factors affecting NDFMS （P<0.05）．Conclusion　The incidence of NDFMS is the result of multiple factors.The primiparity，maternal height and the gestational weight gain are the high risk factors of NDFMS.Properly increasing the intake of fruit on the basis of reasonable diet may be the protective factor of NDFMS.

Key words: Fetal macrosomia, Pregnant women, Weight gain, Diet, Root cause analysis