Carolinas Medical Center, Charlotte, North Carolina 28203, USA.
Am J Perinatol. 2012 Sep;29(8):643-8. doi: 10.1055/s-0032-1314884. Epub 2012 May 29.
To examine the effect of obesity on maternal and neonatal outcomes in women diagnosed with gestational diabetes mellitus (GDM) and managed with diet only, glyburide, or insulin.
Women with singleton gestations enrolled for outpatient services diagnosed with GDM and without history of pregnancy-related hypertension at enrollment or in a prior pregnancy were identified in a database. Women with GDM controlled by diet only (n = 3918), glyburide (n = 873), or insulin without prior exposure to oral hypoglycemic agents (n = 2229) were included. Pregnancy outcomes were compared for obese versus nonobese women within each treatment group and also compared across treatment groups within the obese and nonobese populations.
Within each treatment group, obesity was associated with higher rates of cesarean delivery, pregnancy-related hypertension, macrosomia, and hyperbilirubinemia (all p < 0.05). Higher rates of pregnancy-related hypertension and hyperbilirubinemia were observed in women receiving glyburide.
Obesity adversely affects pregnancy outcome in women with GDM. Higher rates of pregnancy-related hypertension and hyperbilirubinemia were observed in pregnant women receiving glyburide.
探讨仅通过饮食、格列本脲或胰岛素控制的单纯饮食、格列本脲或胰岛素治疗的妊娠期糖尿病（GDM）女性中肥胖对母婴结局的影响。
在数据库中确定了参加门诊服务的单胎妊娠、入组时无妊娠相关高血压病史或既往妊娠相关高血压病史的女性，并诊断为 GDM。纳入仅通过饮食（n = 3918）、格列本脲（n = 873）或胰岛素（无口服降糖药暴露史 n = 2229）控制的 GDM 女性。比较每个治疗组内肥胖和非肥胖女性的妊娠结局，并比较肥胖和非肥胖人群中各治疗组之间的妊娠结局。
在每个治疗组中，肥胖与更高的剖宫产率、妊娠相关高血压、巨大儿和高胆红素血症相关（均 P < 0.05）。接受格列本脲治疗的女性妊娠相关高血压和高胆红素血症的发生率更高。
肥胖对 GDM 女性的妊娠结局有不利影响。接受格列本脲治疗的孕妇妊娠相关高血压和高胆红素血症的发生率更高。
