Boriboonhirunsarn Dittakarn
Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Obstet Gynaecol Res. 2017 Mar;43(3):462-467. doi: 10.1111/jog.13231. Epub 2016 Dec 27.
The objective of this study was to determine the relationship between second trimester weight gain and the risk of gestational diabetes (GDM) after normal first trimester screening.
A total of 195 women at risk for GDM who had normal first trimester screening results were enrolled. The study group consisted of 65 women who had second trimester weight gain > 7 kg, while another 130 women with weight gain ≤ 7 kg served as the comparison group, matched 1:2 by pre-pregnancy body mass index. GDM screening was repeated during 24-28 weeks of gestation and the incidence of GDM was compared between the groups. Other possible associated factors were evaluated.
Mean age, pre-pregnancy body mass index, parity, GDM risks, first trimester weight gain, timing of GDM screening and initial test results were comparable between the groups. The incidence of GDM was significantly higher in the study than in the comparison group (24.6% vs 10.8%, P = 0.012). Logistic regression analysis showed that second trimester weight gain >7 kg and an abnormal 1 oral glucose tolerance test value on first trimester screening independently increased the risk of GDM (adjusted odds ratio 2.6, 95% confidence interval 1.13-6.0, P = 0.025 and 8.36, 95% confidence interval 2.62-26.66, P < 0.001, respectively).
Second trimester weight gain > 7 kg and an abnormal 1 oral glucose tolerance test value at first screening increased the risk of GDM in at-risk women.
本研究的目的是确定孕早期筛查正常后，孕中期体重增加与妊娠期糖尿病（GDM）风险之间的关系。
共纳入195名孕早期筛查结果正常的GDM高危女性。研究组由65名孕中期体重增加>7 kg的女性组成，另外130名体重增加≤7 kg的女性作为对照组，根据孕前体重指数按1:2匹配。在妊娠24 - 28周期间重复进行GDM筛查，并比较两组之间GDM的发生率。评估其他可能的相关因素。
两组之间的平均年龄、孕前体重指数、产次、GDM风险、孕早期体重增加、GDM筛查时间和初始检测结果具有可比性。研究组GDM的发生率显著高于对照组（24.6%对10.8%，P = 0.012）。逻辑回归分析表明，孕中期体重增加>7 kg以及孕早期筛查时口服葡萄糖耐量试验值异常独立增加了GDM的风险（调整后的优势比分别为2.6，9五年期国债利率是多少%置信区间1.13 - 6.0，P = 0.025；以及8.36，95%置信区间2.62 - 26.66，P < 0.001）。
孕中期体重增加>7 kg以及首次筛查时口服葡萄糖耐量试验值异常增加了高危女性患GDM的风险。
