Tianjin Women's and Children's Health Center, No. 96 Guizhou Road, Heping District, Tianjin, 300070, China.
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, 300070, China.
BMC Pregnancy Childbirth. 2022 Apr 19;22(1):336. doi: 10.1186/s12884-022-04672-5.
Gestational diabetes mellitus (GDM) is associated with adverse health consequences for women and their offspring. It is associated with maternal body mass index (BMI) and may be associated with gestational weight gain (GWG). But due to the heterogeneity of diagnosis and treatment and the potential effect of GDM treatment on GWG, the association between the two has not been thoroughly clarified. Compared to body weight, BMI has the advantage that it considers height during the whole course of pregnancy. Understanding BMI changes during pregnancy may provide new evidence for the prevention of GDM.
This study investigated the BMI change of pregnant women based on a retrospective study covering all communities in Tianjin, China. According to the results of GDM screening at 24-28 weeks of gestation, pregnancies were divided into the GDM group and the non-GDM group. We compared gestational BMI change and GWG in the two groups from early pregnancy to GDM screening. GWG was evaluated according to the IOM guidelines. Logistic regression was applied to determine the significance of variables with GDM.
A total of 41,845 pregnant women were included in the final analysis (GDM group, n = 4257 vs. non-GDM group, n = 37,588). BMI gain has no significant differences between the GDM and non-GDM groups at any early pregnancy BMI categories (each of 2 kg/m), as well as weight gain (P > 0.05). Early pregnancy BMI was a risk factor for GDM (OR 1.131, 95% CI 1.122-1.139). And BMI gain was associated with a decreased risk of GDM in unadjusted univariate analysis (OR 0.895, 95% CI 0.869-0.922). After adjusting on early pregnancy BMI and other confounding factors, the effect of BMI gain was no longer significant (AOR 1.029, 95% CI 0.999-1.061), as well as weight gain (AOR 1.006, 95% CI 0.995-1.018) and GWG categories (insufficient: AOR 1.016, 95% CI 0.911-1.133; excessive: AOR 1.044, 95% CI 0.957-1.138).
BMI in early pregnancy was a risk factor for GDM, while BMI gain before GDM screening was not associated with the risk of GDM. Therefore, the optimal BMI in early pregnancy is the key to preventing GDM.
妊娠期糖尿病（GDM）与母婴健康不良后果相关。它与母体体重指数（BMI）相关，并且可能与妊娠体重增加（GWG）相关。但是，由于诊断和治疗的异质性以及 GDM 治疗对 GWG 的潜在影响，两者之间的关联尚未得到彻底阐明。与体重相比，BMI 在整个孕期考虑到了身高，了解孕期 BMI 的变化可能为预防 GDM 提供新的证据。
本研究基于一项涵盖中国天津所有社区的回顾性研究，调查了孕妇的 BMI 变化。根据 24-28 周妊娠时 GDM 筛查的结果，将妊娠分为 GDM 组和非 GDM 组。我们比较了两组从孕早期到 GDM 筛查时的妊娠 BMI 变化和 GWG。GWG 根据 IOM 指南进行评估。应用 logistic 回归确定与 GDM 相关的变量的显著性。
共纳入 41845 名孕妇进行最终分析（GDM 组，n=4257；非 GDM 组，n=37588）。在任何早期妊娠 BMI 类别（每个类别增加 2kg/m）中，GDM 组和非 GDM 组的 BMI 增加均无显著差异，体重增加也无显著差异（P＞0.05）。早期妊娠 BMI 是 GDM 的危险因素（OR 1.131，95%CI 1.122-1.139）。在未调整的单因素分析中，BMI 增加与 GDM 风险降低相关（OR 0.895，95%CI 0.869-0.922）。在校正早期妊娠 BMI 和其他混杂因素后，BMI 增加的作用不再显著（AOR 1.029，95%CI 0.999-1.061），体重增加（AOR 1.006，95%CI 0.995-1.018）和 GWG 类别（不足：AOR 1.016，95%CI 0.911-1.133；过多：AOR 1.044，95%CI 0.957-1.138）也无显著差异。
孕早期 BMI 是 GDM 的危险因素，而 GDM 筛查前的 BMI 增加与 GDM 风险无关。因此，孕早期的最佳 BMI 是预防 GDM 的关键。
