Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland; Service of Endocrinology, Diabetes and Metabolism, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Diabetes Res Clin Pract. 2020 Jul;165:108238. doi: 10.1016/j.diabres.2020.108238. Epub 2020 Jun 2.
To assist preventive strategies, we investigated the predictors and consequences of postpartum weight retention (PPWR) in the early and late postpartum period in women with gestational diabetes (GDM).
862 women with GDM between 2011 and 2019 were prospectively included. We investigated PPWR at 6-8 weeks (n = 862) and at 1-year (n = 259) postpartum. Potential predictors included gestational weight gain (GWG), weight, BMI, and glucose control parameters during and after pregnancy.
Mean PPWR at 6-8 weeks and 1-year postpartum were 4.6 ± 5.7 kg and 4.0 ± 7.4 kg. The proportion of women with PPWR at 6-8 weeks and at 1-year postpartum were 81% and 66.4% respectively. At 6-8 weeks postpartum, women with PPWR had higher pre-pregnancy weight, 7.5 ± 0.2 kg higher GWG and higher postpartum weight (all p ≤ 0.02), without presenting metabolic differences. At 1-year postpartum, there were no differences in anthropometric parameters before and during pregnancy between women with or without PPWR, except for a 4 ± 0.4 kg higher GWG (p < 0.001). However, women with PPWR had increased postpartum weight and BMI, higher fasting glucose and more pronounced increase in Δfasting glucose and ΔHbA1c at 1-year postpartum (all p ≤ 0.03). GWG predicted higher PPWR at both 6-8 weeks and at 1-year postpartum (all p < 0.001).
Women with PPWR had increased anthropometric parameters and adverse metabolic consequences at 1-year postpartum. GWG was the most relevant predictor of PPWR.
为了协助制定预防策略，我们调查了患有妊娠期糖尿病（GDM）的女性在产后早、晚期发生产后体重滞留（PPWR）的预测因素和后果。
2011 年至 2019 年期间前瞻性纳入了 862 例 GDM 女性。我们在产后 6-8 周（n=862）和 1 年（n=259）时调查了 PPWR。潜在的预测因素包括妊娠体重增加（GWG）、体重、BMI 和妊娠及产后期间的血糖控制参数。
产后 6-8 周和 1 年时的平均 PPWR 分别为 4.6±5.7kg 和 4.0±7.4kg。6-8 周和 1 年后发生 PPWR 的女性比例分别为 81%和 66.4%。产后 6-8 周时，PPWR 的女性孕前体重更高，GWG 高 7.5±0.2kg，产后体重更高（所有 p 值均≤0.02），但代谢差异无统计学意义。产后 1 年时，PPWR 女性的孕前和孕期体重等各项人体测量参数与无 PPWR 女性之间无差异，除 GWG 高 4±0.4kg（p＜0.001）外。然而，PPWR 的女性产后体重和 BMI 更高，空腹血糖更高，产后 1 年时空腹血糖和 ΔHbA1c 的增加更明显（所有 p 值均≤0.03）。GWG 可预测产后 6-8 周和 1 年时的更高的 PPWR（所有 p 值均＜0.001）。
PPWR 的女性在产后 1 年时的人体测量参数和代谢不良后果更高。GWG 是 PPWR 的最相关预测因素。
