Weschenfelder Friederike, Hein Friederike, Lehmann Thomas, Schleußner Ekkehard, Groten Tanja
Department of Obstetrics, University Hospital Jena, 07747 Jena, Germany.
Institute of Medical Statistics and Computer Science, University Hospital Jena, Friedrich Schiller University, 07747 Jena, Germany.
J Clin Med. 2021 Jan 18;10(2):348. doi: 10.3390/jcm10020348.
The aim of diabetes care of pregnant women with gestational diabetes mellitus (GDM) is to attain pregnancy outcomes including rates of large-for-gestational-age (LGA) newborns, pre-eclampsia, C-sections (CS) and other neonatal outcomes similar to those of the non-GDM pregnant population. Obesity and excessive weight gain during pregnancy have been shown to also impact perinatal outcome. Since GDM is frequently associated with elevated body mass index (BMI), we evaluated the impact of maternal prepregnancy BMI, development of GDM and gestational weight gain (GWG) during pregnancy on perinatal outcome. We compared 614 GDM patients with 5175 non-diabetic term deliveries who gave birth between 2012 and 2016. Multivariate regression analysis was used to evaluate the independent contribution of each factor on selected perinatal outcome variables. Additionally, subgroup analysis for obese (BMI ≥ 30 kg/m) and non-obese women (BMI < 30 kg/m) was performed. LGA was significantly influenced by BMI, GWG and GDM, while Neonatal Intensive Care Unit (NICU) admission was solely impacted by GDM. Maternal outcomes were not dependent on GDM but on GWG and prepregnancy BMI. These results remained significant in the non-obese subgroup only. Thus, GDM still affects perinatal outcomes and requires further improvement in diabetic care and patient counseling.
患有妊娠期糖尿病（GDM）的孕妇的糖尿病护理目标是实现与非GDM孕妇群体相似的妊娠结局，包括大于胎龄（LGA）新生儿率、子痫前期、剖宫产（CS）及其他新生儿结局。研究表明，肥胖和孕期体重过度增加也会影响围产期结局。由于GDM常与体重指数（BMI）升高相关，我们评估了孕妇孕前BMI、GDM的发生以及孕期体重增加（GWG）对围产期结局的影响。我们比较了2012年至2016年间分娩的614例GDM患者和5175例非糖尿病足月分娩患者。采用多变量回归分析来评估各因素对选定围产期结局变量的独立贡献。此外，还对肥胖（BMI≥30 kg/m）和非肥胖女性（BMI<30 kg/m）进行了亚组分析。LGA受BMI、GWG和GDM的显著影响，而新生儿重症监护病房（NICU）入院仅受GDM影响。孕产妇结局不取决于GDM，而是取决于GWG和孕前BMI。这些结果仅在非肥胖亚组中具有显著性。因此，GDM仍然会影响围产期结局，糖尿病护理和患者咨询需要进一步改善。
