Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
J Diabetes Investig. 2019 Jul;10(4):1075-1082. doi: 10.1111/jdi.12989. Epub 2019 Jan 11.
AIMS/INTRODUCTION: The aim of the present study was to examine the associations of pregestational body mass index (BMI) and gestational weight change with birthweight for gestational age in Japanese mothers with gestational diabetes mellitus (GDM).
We retrospectively examined the clinical and laboratory characteristics of 101 mothers with GDM (pregestational BMI 24.7 ± 5.8 kg/m ; maternal age at delivery 34.7 ± 5.1 years; gestational age 38.5 ± 1.4 weeks) at a single center from January 2011 to December 2016.
Gestational weight changes were 6.22 ± 5.39 kg, and infant birthweights were 2,987.3 ± 393.6 g. Multivariable analysis showed that, in all mothers, pregestational BMI and gestational weight change were positively associated with infant birthweight (P < 0.001 and P = 0.007, respectively). Pregestational BMI, but not gestational weight change, was positively associated with infant birthweight (P = 0.007) in 31 mothers with GDM who had pregestational BMI ≥25 kg/m ; in 68 mothers with GDM who had pregestational BMI 18.5-24.9 kg/m , only gestational weight gain was positively associated with infant birthweight (P = 0.039). Two mothers had pregestational BMI <18.5 kg/m . No statistically significant interactions of pregestational BMI with gestational weight change were found (P = 0.158).
In mothers with GDM, pregestational BMI ≥25 kg/m and excessive gestational weight gain were significantly associated with increased infant birthweight. A prospective multicenter clinical study enrolling a larger number of mothers with GDM will be required to verify the effects of adequately controlling pregestational and gestational weights on infant birthweight for gestational age.
目的/引言：本研究旨在探讨日本妊娠糖尿病（GDM）母亲的孕前体重指数（BMI）和妊娠体重变化与胎儿出生体重与胎龄的关系。
我们回顾性地检查了 2011 年 1 月至 2016 年 12 月在一家中心的 101 例 GDM 母亲（孕前 BMI 24.7±5.8kg/m；分娩时母亲年龄 34.7±5.1 岁；妊娠 38.5±1.4 周）的临床和实验室特征。
妊娠体重变化为 6.22±5.39kg，婴儿出生体重为 2987.3±393.6g。多变量分析显示，在所有母亲中，孕前 BMI 和妊娠体重变化与婴儿出生体重呈正相关（P<0.001 和 P=0.007）。在 31 例孕前 BMI≥25kg/m 的 GDM 母亲中，孕前 BMI 但不是妊娠体重变化与婴儿出生体重呈正相关（P=0.007）；在 68 例孕前 BMI 为 18.5-24.9kg/m 的 GDM 母亲中，只有妊娠体重增加与婴儿出生体重呈正相关（P=0.039）。有 2 例母亲孕前 BMI<18.5kg/m。未发现孕前 BMI 与妊娠体重变化之间存在统计学显著交互作用（P=0.158）。
在 GDM 母亲中，孕前 BMI≥25kg/m 和妊娠体重过度增加与婴儿出生体重增加显著相关。需要进行一项前瞻性的多中心临床研究，纳入更多的 GDM 母亲，以验证适当控制孕前和孕期体重对胎儿出生体重与胎龄的影响。
