Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
NMPA Key Laboratory for Real World Data Research and Evaluation in Hainan, Chengdu, 610041, China.
Reprod Biol Endocrinol. 2022 Jun 22;20(1):92. doi: 10.1186/s12958-022-00964-9.
The impact of maternal pre-pregnancy bodyweight on gestational diabetes mellitus (GDM) following assisted reproductive technology (ART) treatment has been insufficiently investigated. The aim of this study was to investigate the association between maternal pre-pregnancy bodyweight and GDM following ART.
From January 2014 to March 2019, this population-based retrospective cohort study included pregnancies achieved by ART treatment in a pregnancy registration database in China. Multivariate regression analysis and restricted cubic splines were used to explore the association between bodyweight and GDM.
A total of 6,598 pregnancies were included. The incidence of GDM was 26.0% (1715/6598). A total of 868 (13.2%) pregnant women were underweight, 665 (10.8%) were overweight, and 145 (2.20%) were obesity. We found a linear dose-response relation between maternal body mass index and GDM by restricted cubic splines, where one unit body mass index increase was associated with the 15% elevated risk of GDM (adjusted odds ratio [OR] 1.15, 95% CI 1.08-1.22). Compared to the normal weight group, maternal underweight was associated with lower risk of GDM (adjusted OR 0.68, 95% CI 0.57-0.82), while increased risk was found for overweight (adjusted OR 1.54 95% CI 1.29-1.84) and obesity (adjusted OR 1.74, 95% CI 1.23-2.47).
Our study found a linear dose-effect relationship between pre-pregnancy bodyweight and GDM following ART treatment. The findings in this study support the clinical recommendation of advising women with overweight or obesity to lose weight prior to ART treatment.
辅助生殖技术（ART）治疗后，母体孕前体重对妊娠期糖尿病（GDM）的影响尚未得到充分研究。本研究旨在探讨 ART 治疗后母体孕前体重与 GDM 的关系。
本基于人群的回顾性队列研究纳入了中国妊娠登记数据库中通过 ART 治疗获得的妊娠。采用多变量回归分析和限制立方样条来探讨体重与 GDM 的关系。
共纳入 6598 例妊娠，GDM 的发生率为 26.0%（1715/6598）。共有 868（13.2%）例孕妇体重不足，665（10.8%）例超重，145（2.20%）例肥胖。通过限制立方样条，我们发现母体体重指数与 GDM 之间存在线性剂量反应关系，体重指数每增加一个单位，GDM 的风险就会增加 15%（调整后的优势比 [OR] 1.15，95% CI 1.08-1.22）。与正常体重组相比，母体体重不足与 GDM 的风险较低相关（调整后的 OR 0.68，95% CI 0.57-0.82），而超重（调整后的 OR 1.54，95% CI 1.29-1.84）和肥胖（调整后的 OR 1.74，95% CI 1.23-2.47）则与 GDM 的风险增加相关。
我们的研究发现，ART 治疗后，孕前体重与 GDM 之间存在线性剂量效应关系。本研究的结果支持了临床建议，即建议超重或肥胖的妇女在接受 ART 治疗前减肥。
