生殖医学杂志

目的 了解未产女性孕前体成分的分布特征，为孕前女性优生保健提供指导。方法 选取2020年1月至2023年8月于我院就诊的2 818例孕前未产女性作为研究对象，采用生物电阻抗的方法进行体成分检测。结果 2 818例孕前未产女性平均年龄(28.55±3.27)岁，平均体质量指数(BMI)(22.46±3.59)kg/m²。高达70.09%(1 975例)的孕前女性体脂百分比高于正常值，体脂百分比正常者仅占28.57%(805例)。根据体成分特征进行分型，高体脂正常肌肉型占比最高为39.78%(1 121/2 818),其次为高体脂低肌肉型24.80%(700/2 818),而正常体脂正常肌肉型仅占14.02%(395/2 818)。按年龄分组分析，肥胖相关指标(BMI、内脏脂肪面积、腰围、臂围)在不同年龄组间有显著差异(P<0.05),表现为25～<30岁组年龄段最低，之后随年龄增加而增加。低肌肉型(骨骼肌占比<90%)的孕前女性占比在各年龄段中均超过50%。BMI≥24 kg/m²(39.57%,55/139)和腰围≥80 cm(51.80%,72/139)的孕前女性在≥35岁年龄段比例最高(P<0.05)。相关性分析显示，BMI与体脂百分比、内脏脂肪面积、腰围、臂围之间呈显著正相关(r>0.80,P<0.001)。结论 孕前未产女性主要表现为高体脂百分比体型，尤其年龄≥35岁的女性，以腹型肥胖为主。积极开展孕前女性体成分分析有助于更精准地识别潜在肥胖人群、降低超重/肥胖对育龄期女性健康以及母婴健康的远期影响，便于为孕前优生保健提供指导。

Objective:To explore the characteristics of preconception body composition in nulliparous women, and to provide guidance for preconception care.Methods:A total of 2 818 nulliparous women, who underwent preconception checkups at the First Affiliated Hospital with Nanjing Medical University, were recruited from January 2020 to August 2023. The body composition was detected using bioelectrical impedance analysis.Results:The average age of 2 818 nulliparous women was 28.55±3.27 years old, with an average body mass index(BMI) of 22.46±3.59 kg/m². About 70.09%(1 975 cases) of preconception women had a high percent body fat, while only 28.57%(805 cases) had a normal percent body fat. Based on body composition characteristics, women with the type of high body fat and normal muscle accounted for the highest proportion(39.78%,1 121/2 818),followed by 24.80%(700/2 818) of high body fat and low muscle, and those with normal body fat and normal muscle only accounted for 14.02%(395/2 818). Then the analysis was stratified by age, differences in the distribution of obesity-related indicators(BMI,visceral fat area, circumference of abdomen, arm circumference) were found among different age groups(P<0.05),in which the group with age of 25-<30 showed the lowest proportion, and increased with age. Among all age groups, the proportion of preconception women with low muscle(skeletal muscle mass percentage<90%) was more than 50%. The group with ≥35 years old accounted for the highest proportion in preconception women with BMI ≥24 kg/m²(39.57%,55/139) and circumference of abdomen ≥80 cm(51.80%,72/139)(P<0.05). In addition, a correlation analysis showed a significant positive correlation between BMI and body fat percentage, visceral fat area, circumference of abdomen, and arm circumference, respectively(r>0.80,P<0.001).Conclusions:Nulliparous women are mainly characterized by a high percent body fat, and women with the age of 35 years old and older mainly manifest as abdominal obesity. Therefore, it is necessary to conduct body composition analysis among preconception women which can help to identify the potential obese population, and reduce the impact of overweight/obesity on the health of preconception women, as well as the long-term impact on maternal and infant health, and provide guidance for preconception eugenics.