Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark
Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.
Diabetes Care. 2014 Oct;37(10):2677-84. doi: 10.2337/dc14-0896.
We evaluate the association between gestational weight gain and offspring birth weight in singleton term pregnancies of women with type 1 diabetes.
One hundred fifteen consecutive women referred at <14 weeks were retrospectively classified as underweight (prepregnancy BMI <18.5 kg/m(2); n = 1), normal weight (18.5-24.9; n = 65), overweight (25.0-29.9; n = 39), or obese (≥30.0; n = 10). Gestational weight gain was categorized as excessive, appropriate, or insufficient according to the Institute of Medicine recommendations for each BMI class. Women with nephropathy, preeclampsia, and/or preterm delivery were excluded because of restrictive impact on fetal growth and limited time for total weight gain.
HbA1c was comparable at ∼6.6% (49 mmol/mol) at 8 weeks and ∼6.0% (42 mmol/mol) at 36 weeks between women with excessive (n = 62), appropriate (n = 37), and insufficient (n = 16) gestational weight gain. Diabetes duration was comparable, and median prepregnancy BMI was 25.3 (range 18-41) vs. 23.5 (18-31) vs. 22.7 (20-30) kg/m(2) (P = 0.05) in the three weight gain groups. Offspring birth weight and birth weight SD score decreased across the groups (3,681 [2,374-4,500] vs. 3,395 [2,910-4,322] vs. 3,295 [2,766-4,340] g [P = 0.02] and 1.08 [-1.90 to 3.25] vs. 0.45 [-0.83 to 3.18] vs. -0.02 [-1.51 to 2.96] [P = 0.009], respectively). In a multiple linear regression analysis, gestational weight gain (kg) was positively associated with offspring birth weight (g) (β = 19; P = 0.02) and birth weight SD score (β = 0.06; P = 0.008) when adjusted for prepregnancy BMI, HbA1c at 36 weeks, smoking, parity, and ethnicity.
Higher gestational weight gain in women with type 1 diabetes was associated with increasing offspring birth weight independent of glycemic control and prepregnancy BMI.
我们评估了 1 型糖尿病女性单胎足月妊娠中，孕期体重增加与子代出生体重的相关性。
115 例在<14 周时就诊的连续患者，根据孕前 BMI 将其分为消瘦组（BMI<18.5kg/m²；n=1）、正常体重组（18.5-24.9kg/m²；n=65）、超重组（25.0-29.9kg/m²；n=39）和肥胖组（≥30.0kg/m²；n=10）。根据每个 BMI 类别中美国医学研究所的建议，将孕期体重增加分为过多、适当和不足。由于对胎儿生长的限制影响和总增重的时间限制，将有肾病、子痫前期和/或早产的女性排除在外。
在 8 周和 36 周时，HbA1c 分别在 6.6%（49mmol/mol）左右和 6.0%（42mmol/mol）左右，在孕期体重增加过多（n=62）、适当（n=37）和不足（n=16）的女性之间相似。糖尿病病程相似，孕前 BMI 中位数分别为 25.3（范围 18-41）kg/m²、23.5（18-31）kg/m²和 22.7（20-30）kg/m²（P=0.05）。子代出生体重和出生体重标准差在各组中呈下降趋势（3681[2766-4340]g vs. 3395[2910-4322]g vs. 3295[2766-4340]g，P=0.02）和（1.08[-1.90 至 3.25] vs. 0.45[-0.83 至 3.18] vs. -0.02[-1.51 至 2.96]，P=0.009）。在多元线性回归分析中，在校正孕前 BMI、36 周时的 HbA1c、吸烟、产次、种族等因素后，孕期体重增加（kg）与子代出生体重（g）呈正相关（β=19；P=0.02），与出生体重标准差呈正相关（β=0.06；P=0.008）。
1 型糖尿病女性孕期体重增加与子代出生体重增加有关，与血糖控制和孕前 BMI 无关。
