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母亲肥胖和体重增加对妊娠期糖尿病的影响。

Effect of maternal obesity and weight gain on gestational diabetes mellitus.

机构信息

Department of Family Medicine, Atatürk Education and Research Hospital, Ankara, Turkey.

出版信息

Gynecol Endocrinol. 2013 Feb;29(2):133-6. doi: 10.3109/09513590.2012.730571. Epub 2012 Oct 30.

Abstract

The aim of the study is to evaluate the association between gestational diabetes mellitus (GDM) and maternal obesity and weight gain during pregnancy. A prospective cohort study screened 614 consecutive gravid patients for GDM using 50 g glucose challenge test (GCT). The pregnant women were divided into 4 groups according to their prepregnancy body mass index (BMI). Group I, II, III and IV constituted when the BMI < 18.5 kg/m² (n = 16), 18.5-24.9 kg/m² (n = 455), 25-29.9 kg/m² (n = 122), and >30 kg/m² (n = 21) respectively. All the pregnant women were also evaluated in terms of their weight gain during pregnancy and these cases were recruited in 3 groups as low, ideal and high weight gain groups. Overall, a positive 50 g GCT result was identified in 106/614 (17.8%) women. GDM was further diagnosed in 12/614 (1.95%) of subjects. The prevalence of GDM in Group II, III and IV was 1.31%, 3.28% and 9.52% respectively (p < 0.05). The cases of Group II in first and second trimester and Group III only in second trimester showed statistically significant positive results of 50 g GCT when they had excess weight gain compared to the ones whose weight gain were in normal range. Women planning pregnancy should be educated about the disadvantages of obesity, being over-weight and should be advised to have an ideal prepregnancy BMI and ideal weight gain during pregnancy.

摘要

本研究旨在评估妊娠期糖尿病(GDM)与母体肥胖和孕期体重增加之间的关系。一项前瞻性队列研究使用 50g 葡萄糖筛查试验(GCT)对 614 例连续妊娠患者进行 GDM 筛查。根据患者的孕前体质量指数(BMI)将孕妇分为 4 组。BMI<18.5kg/m²(n=16)、18.5-24.9kg/m²(n=455)、25-29.9kg/m²(n=122)和>30kg/m²(n=21)分别为 I、II、III 和 IV 组。所有孕妇还评估了孕期体重增加情况,并将这些病例分为低、中、高体重增加组。共有 106/614(17.8%)名妇女的 50gGCT 结果呈阳性。12/614(1.95%)的受试者被进一步诊断为 GDM。GDM 在 II、III 和 IV 组中的发生率分别为 1.31%、3.28%和 9.52%(p<0.05)。与体重增加正常的孕妇相比,第 1 至第 2 孕期体重增加过多的 II 组和仅第 2 孕期体重增加过多的 III 组的 50gGCT 结果具有统计学意义。计划妊娠的妇女应接受肥胖、超重的不良影响教育,并应建议其在孕前获得理想的 BMI 和孕期理想的体重增加。

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