Dennedy M C, Avalos G, O'Reilly M W, O'Sullivan E P, Dunne F P
Dept of Endocrinology and Diabetes Mellitus, School of Medicine, National University of Ireland, Galway.
Ir Med J. 2012 May;105(5 Suppl):23-5.
To investigate the effects of raised maternal BMI on pregnancy outcome in glucose tolerant women, using the IADPSG criteria. Prospective observational study of fetal and maternal outcome in a cohort of pregnant women recruited to a universal screening programme for gestational diabetes under the ATLANTIC-DIP partnership. Maternal outcomes included glucose, delivery mode, pregnancy induced hypertension (PIH), preeclampsia (PET), antepartum hemorrhage (APH) and postpartum hemorrhage (PPH). Fetal outcomes included birthweight, congenital malformation, fetal death, neonatal jaundice, hypoglycemia and respiratory distress. Increasing maternal BMI was associated with adverse pregnancy outcomes: higher cesarean section rates, pre-eclamptic toxemia, pregnancy induced hypertension, increased birth weight and congenital malformation. There was also an association between normal range glucose and emergency cesarean section, hypertension of pregnancy and birthweight. In spite of tightening criteria for hyperglycemia during pregnancy, raised BMI is associated with adverse pregnancy outcome.
采用国际糖尿病与妊娠研究组(IADPSG)标准,调查糖耐量正常女性孕期体重指数(BMI)升高对妊娠结局的影响。在大西洋糖尿病预防(ATLANTIC-DIP)合作项目下,对参与妊娠期糖尿病通用筛查项目的一组孕妇的胎儿和母亲结局进行前瞻性观察研究。母亲结局包括血糖、分娩方式、妊娠高血压(PIH)、先兆子痫(PET)、产前出血(APH)和产后出血(PPH)。胎儿结局包括出生体重、先天性畸形、胎儿死亡、新生儿黄疸、低血糖和呼吸窘迫。母亲BMI升高与不良妊娠结局相关:剖宫产率更高、子痫前期、妊娠高血压、出生体重增加和先天性畸形。血糖在正常范围与急诊剖宫产、妊娠高血压和出生体重之间也存在关联。尽管孕期高血糖的诊断标准更加严格,但BMI升高仍与不良妊娠结局相关。