Farah Nadine, McGoldrick Aoife, Fattah Chro, O'Connor Norah, Kennelly Mairead M, Turner Michael J
University College Dublin Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland.
J Reprod Infertil. 2012 Apr;13(2):95-9.
The risk of gestational diabetes mellitus (GDM) in accordance to Body Mass Index (BMI) is often based on studies where the calculation of BMI is frequently self-reported and is usually unreliable. We evaluated the risk of an abnormal oral glucose tolerance test (OGTT) in a population where BMI was measured and selective screening for GDM was practiced.
We carried out a prospective observational study where 1935 white European women with a singleton pregnancy were recruited. In the first trimester maternal height and weight were measured digitally. Statistical analysis was performed using SPSS version 15.0. BMI centiles were calculated from the study population. A Chi-square test was used to test the differences in categorical variables between the groups. A p-value <0.05 was considered significant.
In 1935 women, 547 OGTTs were performed and 70 of these were abnormal. The prevalence of an abnormal OGTT was higher in women with Class 2 and 3 obesity compared to women with Class 1 obesity (23.3% vs. 10.1%, respectively; p= 0.008). The frequency of an abnormal OGTT was higher in women with a BMI ≥90th centile (≥33.1 kg/m (2) ) compared to women with a BMI between the 80th and 90th centiles (≥29.3 and <33.1 kg/mm (2) ), (21.5% vs 8.1% respectively; p = 0.005).
When BMI is measured, we recommend to increase the cut-off point for selective screening of GDM to ≥33.0 kg/m (2) . This may decrease unnecessary obstetric interventions and healthcare costs.
依据体重指数（BMI）得出的妊娠期糖尿病（GDM）风险通常基于一些研究，在这些研究中，BMI的计算常常是自我报告的，通常不可靠。我们在一个测量了BMI并实施GDM选择性筛查的人群中评估了口服葡萄糖耐量试验（OGTT）异常的风险。
我们开展了一项前瞻性观察性研究，招募了1935名单胎妊娠的欧洲白人女性。在孕早期，通过数字方式测量孕妇的身高和体重。使用SPSS 15.0版进行统计分析。根据研究人群计算BMI百分位数。采用卡方检验来检验各组间分类变量的差异。p值<0.05被认为具有统计学意义。
在1935名女性中，进行了547次OGTT，其中70次异常。与1级肥胖女性相比，2级和3级肥胖女性中OGTT异常的患病率更高（分别为23.3%和10.1%；p = 0.008）。与BMI在第80至90百分位数之间（≥29.3且<33.1 kg/m²）的女性相比，BMI≥第90百分位数（≥33.1 kg/m²）的女性中OGTT异常的频率更高（分别为21.5%和8.1%；p = 0.005）。
当测量BMI时，我们建议将GDM选择性筛查的切点提高到≥33.0 kg/m²。这可能会减少不必要的产科干预和医疗保健成本。
