Academic Department of Obstetrics and Gynaecology, Imperial College Faculty of Medicine, Chelsea and Westminster Hospital, London, UK.
BJOG. 2012 Aug;119(9):1091-7. doi: 10.1111/j.1471-0528.2012.03388.x. Epub 2012 Jun 7.
To examine the effect of maternal characteristics, including advancing maternal age, body mass index (BMI), racial origin and development of gestational diabetes mellitus (GDM), on birthweight and the interactions between these factors.
Retrospective analysis of prospectively collected data.
Fifteen maternity units in North West London, between 1988 and 2000.
A cohort of 130 549 pregnant women.
Multivariate regression analysis.
Birthweight z-scores in non-GDM and GDM groups within three main racial groups (white European, black and South Asian women).
Babies born to women with GDM were heavier compared with those born to women with no GDM in all racial groups. In black women with GDM the birthweight z-scores were 0.805 higher, in South Asian women the scores were 0.618 higher and in white European women the scores were 0.437 higher, compared with the respective non-GDM group (P < 0.001 for both comparisons versus white European women), and these differences were much greater at high rather than at low maternal BMIs. Advancing maternal age, increasing BMI, highest diastolic blood pressure, Castair's index, racial group and presence of GDM or smoking were each, individually, significantly associated with birthweight z-scores (P < 0.001 for all variables). After adjusting for possible confounding factors, BMI was positively associated with birthweight z-scores within all racial groups (P < 0.001 for all), irrespective of glycaemic status, but its effect was much greater in women with GDM, particularly in those of non-White origin. After adjusting for possible confounding factors, advancing maternal age was only positively associated with birthweight in women of white European and South Asian racial origin who did not suffer from GDM (P < 0.001 for both).
Gestational diabetes mellitus strongly accentuates the effect of maternal BMI on birthweight, especially within non-white populations.
研究产妇特征（包括高龄产妇、体重指数（BMI）、种族和妊娠期糖尿病（GDM）的发展）对出生体重的影响，并探讨这些因素之间的相互作用。
前瞻性收集数据的回顾性分析。
1988 年至 2000 年期间，伦敦西北部的 15 家产科单位。
一个包含 130549 名孕妇的队列。
多变量回归分析。
非 GDM 和 GDM 组中三个主要种族（白种欧洲人、黑人和南亚人）的出生体重 z 评分。
在所有种族群体中，患有 GDM 的女性所生婴儿的体重比没有 GDM 的女性所生婴儿的体重重。患有 GDM 的黑人女性的出生体重 z 评分高 0.805，南亚女性高 0.618，白种欧洲女性高 0.437，与各自的非 GDM 组相比（与白种欧洲女性相比，两者均 P < 0.001），且这些差异在高 BMI 而非低 BMI 时更大。高龄产妇、BMI 增加、最高舒张压、Castair 指数、种族以及 GDM 或吸烟的存在，单独来看，与出生体重 z 评分均显著相关（所有变量 P < 0.001）。在调整了可能的混杂因素后，BMI 与所有种族群体的出生体重 z 评分均呈正相关（所有 P < 0.001），与血糖状态无关，但在患有 GDM 的女性中，这种相关性更强，尤其是在非白种人群中。在调整了可能的混杂因素后，只有白种欧洲人和南亚人种的非 GDM 女性的年龄增长与出生体重呈正相关（两者均 P < 0.001）。
妊娠期糖尿病极大地加重了 BMI 对出生体重的影响，特别是在非白人群中。
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