From the Division of Research, Kaiser Permanente of Northern California, Oakland, California.
Obstet Gynecol. 2011 Jun;117(6):1323-1330. doi: 10.1097/AOG.0b013e31821aa358.
To estimate the association between interpregnancy change in body mass index (BMI) and the risk of gestational diabetes mellitus (GDM) in a second pregnancy.
In a retrospective cohort analysis of 22,351 women, logistic regression models provided adjusted estimates of the risk of GDM in women gaining 3.0 or more 2.0-2.9, and 1.0-1.9 BMI units, or losing 1.0-2.0 and more than 2.0 units between pregnancies (one BMI unit corresponds to 5.9 pounds for the average height [5 feet 4 inches] of the study population). Women with stable BMIs (±1.0 BMI unit) comprised the reference.
For those with GDM in the first pregnancy, the age-adjusted risk of GDM in the second pregnancy was 38.19% (95% confidence interval [CI] 34.96-41.42); for those whose first pregnancy was not complicated by GDM, the risk was 3.52% (95% CI 3.27-3.76). Compared with women who remained stable, interpregnancy BMI gains were associated with an increased risk of GDM in the second pregnancy (odds ratio [OR] 1.71 [95% CI 1.42-2.07] for gaining 1.0-1.9 BMI units; OR 2.46 [95% CI 2.00-3.02] for 2.0-2.9 BMI units; and OR 3.40 [95% CI 2.81-4.12] for 3.0 or more BMI units). The loss of BMI units was associated with a lower risk of GDM only among women who were overweight or obese in the first pregnancy (OR 0.26 [95% CI 0.14-0.47] for the loss of at least 2.0 BMI units). In overweight and obese women, those with GDM in the first pregnancy that did not develop the condition again gained fewer BMI units than those experiencing recurrent GDM (mean change 0.66 [95% CI 0.25-1.07] compared with 2.00 [95% CI 1.56-2.43] BMI units, respectively).
Interpregnancy increases in BMI between the first and second pregnancy increases a woman's risk of GDM pregnancy.
评估两次妊娠间体重指数（BMI）变化与妊娠糖尿病（GDM）风险之间的关联。
采用 22351 名女性的回顾性队列分析，逻辑回归模型提供了 GDM 风险的调整估计值，这些女性在两次妊娠间体重增加 3.0 个或更多 2.0-2.9 个和 1.0-1.9 个 BMI 单位，或体重减轻 1.0-2.0 个和 2.0 个以上单位（平均身高 [5 英尺 4 英寸] 的研究人群中，一个 BMI 单位相当于 5.9 磅）。BMI 稳定（±1.0 BMI 单位）的女性为参考。
对于首次妊娠患有 GDM 的女性，第二次妊娠 GDM 的年龄调整风险为 38.19%（95%置信区间[CI]34.96-41.42）；对于首次妊娠未并发 GDM 的女性，风险为 3.52%（95%CI3.27-3.76）。与体重稳定的女性相比，两次妊娠间 BMI 增加与第二次妊娠 GDM 的风险增加相关（体重增加 1.0-1.9 BMI 单位的比值比[OR]1.71[95%CI1.42-2.07]；体重增加 2.0-2.9 BMI 单位的 OR2.46[95%CI2.00-3.02]；体重增加 3.0 个或更多 BMI 单位的 OR3.40[95%CI2.81-4.12]）。仅在首次妊娠超重或肥胖的女性中，体重指数的下降与 GDM 风险降低相关（体重减少至少 2.0 BMI 单位的 OR0.26[95%CI0.14-0.47]）。在超重和肥胖女性中，首次妊娠患有 GDM 且未再次发生该疾病的女性体重增加的 BMI 单位少于再次发生 GDM 的女性（体重变化 0.66[95%CI0.25-1.07]与 2.00[95%CI1.56-2.43]BMI 单位，分别）。
两次妊娠间 BMI 的增加会增加女性患 GDM 的风险。
