Department of Obstetrics & Gynecology, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA 01605, United States; Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA 01605, United States.
Department of Obstetrics & Gynecology, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA 01605, United States; Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01605, United States.
Diabetes Metab. 2019 Jan;45(1):26-31. doi: 10.1016/j.diabet.2017.10.006. Epub 2017 Nov 10.
To evaluate the association between gestational weight gain (GWG) in early pregnancy and incidence of abnormal glucose tolerance (AGT) and gestational diabetes mellitus (GDM) among Latinas.
We conducted a retrospective cohort study of 2039 Latinas using pooled data from two medical centres in Massachusetts. Gestational weights were abstracted from medical records and GWG was categorized as low, appropriate and excessive according to 2009 Institute of Medicine Guidelines. Diagnosis of AGT and GDM was confirmed by study obstetricians.
A total of 143 women (7.0%) were diagnosed with GDM and 354 (17.4%) with AGT. After adjusting for age and study site, women with low GWG up to the time of GDM screen had a lower odds of GDM (OR: 0.51, 95% CI: 0.29-0.92). Among overweight women, women with excessive first-trimester GWG had 2-fold higher odds of AGT (OR: 1.96, 95% CI: 1.17-3.30) and GDM (OR: 2.07, 95% CI: 1.04-4.12) compared to those with appropriate GWG; however, these findings were not significant among normal weight or obese women.
Among Latinas, low GWG up to the time of GDM screen was associated with lower odds of AGT and GDM, while excessive GWG among overweight women was associated with higher odds. Findings highlight need for interventions in early pregnancy to help women meet GWG guidelines and to moderate GWG among overweight Latinas.
评估早孕期体重增加（GWG）与拉丁裔女性异常葡萄糖耐量（AGT）和妊娠期糖尿病（GDM）发病率的关系。
我们对马萨诸塞州两家医疗中心的 2039 名拉丁裔女性进行了回顾性队列研究。从病历中提取妊娠体重，根据 2009 年美国医学研究所指南，将 GWG 分为低、适当和过多。AGT 和 GDM 的诊断由研究产科医生确认。
共有 143 名女性（7.0%）被诊断为 GDM，354 名女性（17.4%）被诊断为 AGT。调整年龄和研究地点后，GWG 低至 GDM 筛查时，GDM 的发生几率较低（OR：0.51，95%CI：0.29-0.92）。在超重女性中，与适当 GWG 相比，头三个月 GWG 过多的女性 AGT（OR：1.96，95%CI：1.17-3.30）和 GDM（OR：2.07，95%CI：1.04-4.12）的发生几率高两倍；然而，在正常体重或肥胖女性中，这些发现并不显著。
在拉丁裔女性中，GWG 低至 GDM 筛查时，AGT 和 GDM 的发生几率较低，而超重女性 GWG 过多时，发生几率较高。这些发现强调需要在早孕期间进行干预，以帮助女性符合 GWG 指南，并适度控制超重拉丁裔女性的 GWG。
