Programa de Pós-graduação em Endocrinologia e Metabologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Departamento de Medicina da Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Arch Endocrinol Metab. 2022;66(4):439-445. doi: 10.20945/2359-3997000000499. Epub 2022 Jun 2.
To evaluate the association of neck circumference (NC) with gestational diabetes (GDM) and adverse outcomes in women with overweight and obesity.
This prospective study included 132 (BMI > 25 kg/m) pregnant women without and with GDM. Standardized questionnaire and biochemical/physical evaluation were performed during the 1 to 3 trimester. Fifth-five women were evaluated regarding hypertension in pregnancy, type of delivery and neonatal complications (death, intensive care unit admission and hypoglycemia).
Women with (n = 61) and without (n = 71) GDM had similar mean (SD) pre-gestational BMI [30.3 (4.0) 29.4 (3.5) kg/m, p = 0.16]. Women with GDM were older [32 (6) 28 (6) yrs, p < 0.001] and had greater NC [36.0 (2.7) 34.5 (1.8) cm, p < 0.001]. NC was similar in women with GDM diagnosed in first or third trimester [p = 0.4] and was correlated with FPG [r 0.29, p = 0.01] and systolic [r 0.28, p = 0.001] and diastolic [r 0.25, p = 0.004] blood pressure. NC was associated with GDM [OR 1.25, 95%CI 1.03-1.52] adjusted for age, physical activity, education and familiar history of diabetes. In ROC analysis, the area under the curve was 0.655 and the cut-off value of 34.5 cm had 0.70 of sensitivity and 0.51 of specificity for GDM. Women who had NC ≥ 34.5 < 34.5 cm had higher frequencies of hypertension [32.3 4.2%, p = 0.01].
In a group of pregnant women with overweight or obesity, NC can be a useful tool for identifying risk of GDM and obstetric adverse outcomes.
评估颈围（NC）与超重和肥胖孕妇妊娠糖尿病（GDM）及不良结局的关系。
本前瞻性研究纳入了 132 名（BMI＞25kg/m²）无 GDM 和有 GDM 的孕妇。在 1 至 3 个孕期进行了标准化问卷和生化/体格评估。有 55 名孕妇评估了妊娠期高血压、分娩方式和新生儿并发症（死亡、入住重症监护病房和低血糖）。
有（n=61）和无（n=71）GDM 的孕妇的孕前 BMI 均值（SD）相似[30.3（4.0）kg/m²与 29.4（3.5）kg/m²，p=0.16]。有 GDM 的孕妇年龄更大[32（6）岁与 28（6）岁，p＜0.001]，颈围更大[36.0（2.7）cm 与 34.5（1.8）cm，p＜0.001]。在 GDM 诊断于第一或第三孕期的孕妇中，颈围无差异（p=0.4），且与 FPG[r=0.29，p=0.01]和收缩压[r=0.28，p=0.001]及舒张压[r=0.25，p=0.004]相关。在校正年龄、体力活动、教育和糖尿病家族史后，颈围与 GDM 相关[OR 1.25，95%CI 1.03-1.52]。ROC 分析中，曲线下面积为 0.655，颈围 34.5cm 的截断值对 GDM 的敏感性为 0.70，特异性为 0.51。颈围≥34.5cm＜34.5cm 的孕妇高血压发生率更高[32.3%与 4.2%，p=0.01]。
在超重或肥胖孕妇中，颈围是识别 GDM 及产科不良结局风险的有用工具。
