Arjmandi Far Mitra, Ziaei Saeideh, Kazemnejad Anoshirvan
Midwifery and Reproductive Health Department, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran.
Int J Fertil Steril. 2012 Jan;5(4):207-2010. Epub 2012 Mar 20.
Gestational diabetes mellitus (GDM) complicates 3-7% of all pregnancies and fetomaternal outcomes are strongly related to early diagnosis of GDM. The aim of this study was to determine the impact of risk factors in the prediction of an abnormal glucose challenge test (GCT).
This was a prospective study conducted during 2009-2010 in two prenatal clinics in Rey, Iran. A total of 711 pregnant women who were in their first trimester of pregnancy and met the inclusion criteria were selected. The women were observed once every other week until 24- 28 weeks of gestation. All patients at 24-28 weeks of gestation were screened with 50 g oral glucose GCT. The effects of pre-pregnancy body mass index (BMI), maternal age, and weight gain until the time of GCT, and parity on abnormal GCT were evaluated. All confident intervals were calculated at the 95% level. Data was analyzed using student's t test and the logistic regression test.
Maternal age (p<0.001), pre-pregnancy BMI (p<0.00), parity (p=0.05) and weight gain during pregnancy (p=0.05), were significantly higher in women with abnormal GCT compared to women who had normal GCT. Logistic regression analyses confirmed that pre-pregnancy BMI (OR=1.09), maternal age (OR=1.14), and weight gain during pregnancy (OR=1.13) were associated with abnormal GCT.
Weight gain had a profound impact on the prevalence of abnormal GCT in our population. Therefore, we propose that pregnant women should only gain the recommended amount of weight during pregnancy.
妊娠期糖尿病(GDM)使3%至7%的妊娠出现并发症,胎儿和母亲的结局与GDM的早期诊断密切相关。本研究的目的是确定风险因素对葡萄糖耐量试验(GCT)异常预测的影响。
这是一项于2009年至2010年在伊朗雷伊的两家产前诊所进行的前瞻性研究。共选取了711名处于妊娠早期且符合纳入标准的孕妇。每隔一周观察这些孕妇一次,直至妊娠24至28周。所有妊娠24至28周的患者均接受50克口服葡萄糖GCT筛查。评估孕前体重指数(BMI)、母亲年龄、至GCT时的体重增加以及产次对GCT异常的影响。所有置信区间均在95%水平计算。数据采用学生t检验和逻辑回归检验进行分析。
与GCT正常的女性相比,GCT异常的女性的母亲年龄(p<0.001)、孕前BMI(p<0.00)、产次(p=0.05)和孕期体重增加(p=0.05)显著更高。逻辑回归分析证实,孕前BMI(OR=1.09)、母亲年龄(OR=1.14)和孕期体重增加(OR=1.13)与GCT异常有关。
体重增加对我们研究人群中GCT异常的患病率有深远影响。因此,我们建议孕妇在孕期应仅增加推荐的体重。