Department of Obstetrics and Gynecology, National Hospital Organization Kofu National Hospital, Kofu, Yamanashi, Japan.
PLoS One. 2020 Apr 2;15(4):e0231018. doi: 10.1371/journal.pone.0231018. eCollection 2020.
We aimed to assess the association between postpartum weight retention (PPWR) in the fourth week after delivery and the risk of gestational diabetes mellitus (GDM) in a subsequent pregnancy.
We performed a retrospective cohort study of the obstetric records of women who gave birth to their second singleton between 32 and 41 weeks of gestation at the National Hospital Organization Kofu National Hospital between January 2013 and September 2019. The exclusion criteria were missing data, twin pregnancy, diabetes in pregnancy, and delivery before 22 weeks in the first pregnancy. We calculated PPWR as the BMI 4 weeks after the first birth minus the BMI before the first pregnancy and grouped the subjects into the stable PPWR (gain of <1 BMI unit) and non-stable PPWR groups (gain of ≥1 BMI units). We used the χ2 test and multivariable logistic regression analysis to investigate the association between weight retention at the postpartum checkup and GDM.
We included 566 women in this study (mean age, 31.7±4.8 years; mean maternal pre-pregnancy BMI, 21.3±3.5 kg/m2; term delivery, n = 544 [96.1%]). The overall prevalence of GDM during the second pregnancy was 7.4% (42/566), and 33.9% (192/566) of women had stable PPWR. Non-stable PPWR was not significantly associated with GDM in the second pregnancy (adjusted odds ratio, 1.93; 95% confidence interval, 0.84-4.46) after controlling for each variable.
PPWR measured in the fourth week after delivery was not associated with an increased risk of GDM in the second pregnancy.
评估产后第四周体重滞留（PPWR）与随后妊娠发生妊娠期糖尿病（GDM）的风险之间的关系。
我们对 2013 年 1 月至 2019 年 9 月在日本国立医院组织甲府医院分娩的第二胎单胎妊娠且妊娠 32-41 周的产妇的产科记录进行了回顾性队列研究。排除标准为数据缺失、双胎妊娠、妊娠糖尿病和第一胎分娩前 22 周。我们将产后 4 周的 BMI 减去妊娠前的 BMI，计算产后体重滞留，将受试者分为稳定 PPWR（增重<1 BMI 单位）和非稳定 PPWR（增重≥1 BMI 单位）组。我们使用 χ2 检验和多变量逻辑回归分析来研究产后检查时体重滞留与 GDM 之间的关系。
本研究共纳入 566 名产妇（平均年龄 31.7±4.8 岁；平均孕前 BMI 21.3±3.5kg/m2；足月分娩 544 例[96.1%]）。第二胎妊娠 GDM 的总体患病率为 7.4%（42/566），566 名产妇中有 33.9%（192/566）为稳定 PPWR。在控制每个变量后，非稳定 PPWR 与第二胎妊娠 GDM 无显著相关性（调整后比值比 1.93；95%置信区间 0.84-4.46）。
产后第四周测量的 PPWR 与第二胎妊娠 GDM 的风险增加无关。
