Blickstein Isaac, Doyev Reut, Trojner Bregar Andreja, Bržan Šimenc Gabrijela, Verdenik Ivan, Tul Natasa
a Department of Obstetrics and Gynecology , Kaplan Medical Center , Rehovot , Israel.
b Hadassah-Hebrew University School of Medicine , Jerusalem , Israel.
J Matern Fetal Neonatal Med. 2018 Mar;31(5):640-643. doi: 10.1080/14767058.2017.1293030. Epub 2017 Mar 1.
To assess the effect of the combination of gestational diabetes mellitus (GDM) and pre-gravid obesity ('diabesity') in singleton gestations.
We compared perinatal outcomes of singleton gestations in mothers with GDM and pre-gravid obesity, with GDM but with normal pre-gravid BMI, and obese mothers without GDM.
We compared diabesity mothers (n = 1525, 24.4% of mothers with GDM, 9.9% of all obese women) to mothers with GDM but with normal BMI (n = 4704, 75.6% of mothers with GDM) and to obese mothers without GDM (n = 13,937, 90.1% of all obese mothers). Obesity, with and without GDM, increased the odds of having chronic hypertension whereas preeclampsia appears to be influenced by obesity only, as were the risk of births at <33 weeks' gestation, of birth weight >4000 g, low 5-min Apgar scores and NICU admissions.
Obesity (without diabetes) is more frequently associated with adverse perinatal outcomes than diabesity or GDM in non-obese mothers. A campaign to decrease pre-gravid obesity should have at least the same priority as any campaign to control GDM.
评估妊娠期糖尿病（GDM）与孕前肥胖（“糖尿病肥胖症”）合并存在对单胎妊娠的影响。
我们比较了患有GDM且孕前肥胖、患有GDM但孕前BMI正常的单胎妊娠母亲以及未患GDM的肥胖母亲的围产期结局。
我们将糖尿病肥胖症母亲（n = 1525，占患有GDM母亲的24.4%，占所有肥胖女性的9.9%）与患有GDM但BMI正常的母亲（n = 4704，占患有GDM母亲的75.6%）以及未患GDM的肥胖母亲（n = 13937，占所有肥胖母亲的90.1%）进行了比较。无论是否患有GDM，肥胖都会增加患慢性高血压的几率，而子痫前期似乎仅受肥胖影响，妊娠<33周分娩、出生体重>4000 g、5分钟阿氏评分低以及入住新生儿重症监护病房的风险也是如此。
在非肥胖母亲中，肥胖（无糖尿病）比糖尿病肥胖症或GDM更常与不良围产期结局相关。降低孕前肥胖的运动应与控制GDM的任何运动具有至少同等的优先级。
