Department of Obstetrics, Gynecology and Reproductive Sciences, Magee Women's Research Institute, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Obstet Gynecol. 2014 Jun;123(6):1295-1302. doi: 10.1097/AOG.0000000000000271.
To evaluate the prevalence and clinical effects of excess gestational weight gain on birth weight and other pregnancy outcomes in women with type 1 diabetes.
We performed a retrospective cohort study of women with type 1 diabetes delivered between 2009 and 2012. Patients with excess weight gain were identified using the 2009 Institute of Medicine weight gain recommendations adjusted for gestational age at delivery and prepregnancy body mass index (BMI) category. Demographic and outcome data were abstracted from the medical record, and pregnancy outcomes were compared between women with and without excess gestational weight gain.
Excess gestational weight gain occurred in 114 of 175 women (65.1%). Large-for-gestational-age (LGA) birth weight occurred in 48 of 114 (42.1%) of women with excess gestational weight gain and 5 of 61 (8.2%) of women with recommended weight gain (P<.001). The association between excess maternal weight gain and LGA birth weight remained significant after adjustment for prepregnancy BMI, gestational age at delivery, nulliparity, vascular complications, and hemoglobin A1c measurements (adjusted odds ratio 8.9, 95% confidence interval 3.1-26.2, P<.001). Stratified analyses demonstrated that excess maternal weight gain is associated with LGA neonates in both normal-weight and overweight or obese women.
Excess maternal weight gain is common and leads to higher rates of LGA neonates in both normal-weight and overweight or obese women with type 1 diabetes. Interventions designed to limit excess gestational weight gain may reduce the risk for fetal overgrowth in women with type 1 diabetes.
II.
评估 1 型糖尿病女性中妊娠体重过度增加对出生体重和其他妊娠结局的流行率和临床影响。
我们对 2009 年至 2012 年期间分娩的 1 型糖尿病女性进行了回顾性队列研究。通过调整与分娩时的孕龄和孕前体重指数（BMI）类别相关的 2009 年医学研究所体重增加建议，确定体重增加过多的患者。从病历中提取人口统计学和结局数据，并比较有和无妊娠体重过度增加的女性之间的妊娠结局。
175 名女性中有 114 名（65.1%）发生妊娠体重过度增加。体重过大儿（LGA）的出生体重在体重过度增加的 114 名女性中发生 48 例（42.1%），在体重增加推荐的 61 名女性中发生 5 例（8.2%）（P<.001）。在校正孕前 BMI、分娩时的孕龄、初产妇、血管并发症和血红蛋白 A1c 测量值后，母体体重过度增加与 LGA 出生体重之间的关联仍然显著（调整后的优势比 8.9，95%置信区间 3.1-26.2，P<.001）。分层分析表明，体重过度增加的母亲与正常体重和超重或肥胖的 1 型糖尿病女性的 LGA 新生儿有关。旨在限制妊娠体重过度增加的干预措施可能会降低 1 型糖尿病女性胎儿过度生长的风险。
II。
