Department of Food Science and Nutrition, Laval University, 2440 Hochelaga Blvd., Quebec City, Canada.
J Womens Health (Larchmt). 2011 Mar;20(3):375-80. doi: 10.1089/jwh.2010.2252. Epub 2011 Feb 19.
Gestational diabetes mellitus (GDM) and excessive gestational weight gain have significant implications for the health of both mother and child. Our objective was to detail gestational weight gain in women in relationship to GDM.
Data were collected by retrospective reviews of medical records in women who delivered between January and December 2007 at the Laval University Medical Center (Quebec, Canada). The analysis included 294 women (55 GDM and 239 controls) for whom gestational weight gain was calculated by the difference between maternal weight measured at delivery, or at the last prenatal visit (≥37th week), and prepregnancy self-reported weight. Gestational weight gain and rate of weight gain were also calculated for each trimester and until GDM screening. Gestational weight gain was compared to the 2009 recommendations by the Institute of Medicine (IOM). Women with GDM were diagnosed and treated according to the Canadian Diabetes Association guidelines.
Weight gain in the first trimester was significantly higher in GDM patients compared to controls (3.40 ± 0.42 vs. 1.87 ± 0.16 kg, p ≤ 0.01) and was above IOM recommendations, whereas weight gain in the third trimester was significantly lower in GDM patients compared to controls (4.11 ± 0.36 vs. 6.35 ± 0.18 kg, p ≤ 0.0001). Prepregnancy body mass index (BMI) and first trimester weight gain were both significant and independent predictors of GDM (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.05-1.17, and OR 1.25, 95% CI 1.10-1.42, respectively).
First trimester gestational weight gain may need more clinical attention, as it has been identified as an independent and significant risk factor for GDM independent of traditional risk factors, including preconception obesity.
妊娠糖尿病（GDM）和过度的妊娠体重增加对母婴健康都有重要影响。我们的目的是详细描述与 GDM 相关的女性妊娠体重增加。
数据通过对 2007 年 1 月至 12 月在加拿大魁北克省拉瓦尔大学医疗中心分娩的妇女的病历进行回顾性收集。分析包括 294 名妇女（55 名 GDM 和 239 名对照），通过分娩时或最后一次产前检查（≥37 周）时测量的母体体重与孕前自我报告的体重之间的差异来计算妊娠体重增加。还计算了每个孕早期、孕中期和孕晚期直至 GDM 筛查的体重增加率。将妊娠体重增加与 2009 年美国医学研究所（IOM）的建议进行了比较。根据加拿大糖尿病协会的指南诊断和治疗 GDM 患者。
GDM 患者的孕早期体重增加明显高于对照组（3.40±0.42 vs. 1.87±0.16 kg，p≤0.01），且高于 IOM 建议值，而 GDM 患者的孕晚期体重增加明显低于对照组（4.11±0.36 vs. 6.35±0.18 kg，p≤0.0001）。孕前体重指数（BMI）和孕早期体重增加均是 GDM 的显著独立预测因素（优势比 [OR] 1.11，95%置信区间 [CI] 1.05-1.17 和 OR 1.25，95%CI 1.10-1.42）。
孕早期的妊娠体重增加可能需要更多的临床关注，因为它已被确定为 GDM 的独立和显著危险因素，独立于传统危险因素，包括孕前肥胖。
