From the Division of Research, Kaiser Permanente Medical Care Program of Northern California, Oakland, California.
Obstet Gynecol. 2010 Mar;115(3):597-604. doi: 10.1097/AOG.0b013e3181cfce4f.
To estimate the relationship between the rate of gestational weight gain before the 50-g, 1-hour oral glucose challenge test screening for gestational diabetes mellitus (GDM) and subsequent risk of GDM.
We conducted a nested case-control study (345 women with GDM and 800 women in the control group) within a multiethnic cohort of women delivering between 1996 and 1998 who were screened for GDM at 24-28 weeks of gestation. GDM was diagnosed according to the National Diabetes Data Group plasma glucose cut-offs for the 100-g, 3-hour oral glucose tolerance test. Women's plasma glucose levels, weights, and covariate data were obtained by medical record chart review.
After adjusting for age at delivery, race/ethnicity, parity, and prepregnancy body mass index, the risk of GDM increased with increasing rates of gestational weight gain. Compared with the lowest tertile of rate of gestational weight gain (less than 0.27 kg/week [less than 0.60 lb/wk]), a rate of weight gain from 0.27-0.40 kg/wk (0.60-0.88 lb/wk) and 0.41 kg/wk (0.89 lb/wk) or more, were associated with increased risks of GDM (odds ratio 1.43, 95% confidence interval 0.96-2.14; and odds ratio 1.74, 95% confidence interval 1.16-2.60, respectively). The association between the rate of gestational weight gain and GDM was primarily attributed to increased weight gain in the first trimester. The association was stronger in overweight [corrected] and nonwhite women.
High rates of gestational weight gain, especially early in pregnancy, may increase a woman's risk of GDM. Gestational weight gain during early pregnancy may represent a modifiable risk factor for GDM and needs more attention from health care providers.
评估在进行妊娠期糖尿病（GDM）50 克 1 小时口服葡萄糖耐量试验筛查之前的体重增加率与随后发生 GDM 的风险之间的关系。
我们对 1996 年至 1998 年期间分娩的多民族队列中的 345 名 GDM 妇女和 800 名对照组妇女进行了嵌套病例对照研究。GDM 的诊断依据是全国糖尿病数据组针对 100 克 3 小时口服葡萄糖耐量试验的血浆葡萄糖切点。通过病历图表回顾获取妇女的血浆葡萄糖水平、体重和协变量数据。
在调整了分娩年龄、种族/民族、产次和孕前体重指数后，GDM 的风险随体重增加率的增加而增加。与体重增加率最低的三分位数（<0.27 kg/周 [<0.60 lb/周]）相比，体重增加率为 0.27-0.40 kg/周（0.60-0.88 lb/周）和 0.41 kg/周（0.89 lb/周）或更高的妇女发生 GDM 的风险增加（比值比 1.43，95%置信区间 0.96-2.14；比值比 1.74，95%置信区间 1.16-2.60）。体重增加率与 GDM 之间的关联主要归因于孕早期体重增加增加。超重[更正]和非白人妇女的关联更强。
高体重增加率，尤其是孕早期的体重增加率，可能会增加妇女发生 GDM 的风险。孕早期的体重增加可能是 GDM 的一个可改变的危险因素，需要医疗保健提供者更多的关注。
