Liang Yi, Li Dan-Ting, Chen Meng-Xue, Gong Yun-Hui, Zhang Xiao, Yang Wen-Yan, Liu Ying, Cheng Guo, Yang Da-Gang
Department of Nutrition, Food Safety and Toxicology, West China School of Public Health, Sichuan University, Chengdu 610041, China.
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2019 Jan;50(1):83-87.
To determine the associations of pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with gestational diabetes mellitus (GDM).
A prospective cohort of pregnant women were screened for GDM at 24-28 weeks of gestation between 2013 and 2015, resulting in a sample of 3 593 with GDM and 15 346 without GDM. The body mass, plasma glucose, and height data of the participants were collected by the local medical workers. Multivariate logistic regression analyses were performed to determine the associations of pre pregnancy body mass index and weight gain during pregnancy with GDM.
The participants with pre pregnancy overweight [odds ratio()=2.44, 95% cofidence interval()1.98-2.99] and obesity (=4.98, 95% 2.52-9.91) were more likely to develop GDM. According to the Institute of Medicine (IOM) criteria, excessive GWG in the first trimester occurred in 8.46% of the women, compared with 55.07% in the second trimester. After adjustment for age at delivery and pre pregnancy BMI, high GWG in the first trimesters in advanced maternal age (age at delivery≥35 yr.) group (1.42, 95% 1.02-2.28) was a risk factor for GDM while the value of the non-advanced maternal age (age at delivery≤35 yr.) group was not statistically significant. In second trimesters, both advanced maternal age group (1.59, 95% 1.14-1.88) and non-advanced maternal age group (1.49, 95% 1.20-1.72) in high GWG were associated with high risk of GDM.
Pre pregnancy overweight and obesity and excessive GWG during early and second trimesters of pregnancy may increase the risk of GDM in women in Southwestern China.
确定孕前体重指数（BMI）和孕期体重增加（GWG）与妊娠期糖尿病（GDM）之间的关联。
对2013年至2015年期间妊娠24 - 28周的孕妇进行前瞻性队列研究，筛查GDM，最终纳入3593例GDM患者和15346例非GDM患者作为样本。参与者的体重、血糖和身高数据由当地医务人员收集。进行多因素逻辑回归分析，以确定孕前体重指数和孕期体重增加与GDM之间的关联。
孕前超重[比值比（OR）=2.44，95%置信区间（CI）1.98 - 2.99]和肥胖（OR =4.98，95% CI 2.52 - 9.91）的参与者更易患GDM。根据美国医学研究所（IOM）标准，孕早期GWG过多的女性占8.46%，而孕中期为55.07%。在调整分娩年龄和孕前BMI后，高龄产妇（分娩年龄≥35岁）组孕早期GWG过高（OR =1.42，95% CI 1.02 - 2.28）是GDM的危险因素，而非高龄产妇（分娩年龄≤35岁）组的OR值无统计学意义。在孕中期，高龄产妇组（OR =1.59，95% CI 1.14 - 1.88）和非高龄产妇组（OR =1.49，95% CI 1.20 - 1.72）中GWG过高均与GDM高风险相关。
孕前超重和肥胖以及孕早期和孕中期GWG过多可能增加中国西南部女性患GDM的风险。
