Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
J Diabetes Investig. 2023 Apr;14(4):614-622. doi: 10.1111/jdi.13977. Epub 2023 Feb 3.
AIMS/INTRODUCTION: In Japan, the increasing frequency of underweight among women of reproductive age and the accompanying increase in the rate of low birth weight (LBW) are social issues. The study aimed to establish a prospective registry system for gestational diabetes mellitus (GDM) in Japan and to clarify the actual status of GDM according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria.
Pregnant women with gestational diabetes mellitus and those in the normal glucose tolerance (NGT) group were enrolled in the Diabetes and Pregnancy Outcome for Mother and Baby study from October 2015. Pregnant women with positive glucose screening in early and mid-to-late pregnancy underwent a 75 g oral glucose tolerance test by gestational week 32. Gestational diabetes mellitus was diagnosed according to IADPSG criteria. Women with a positive glucose screening test at mid-to-late pregnancy but NGT were enrolled as references (NGT group). Treatment for gestational diabetes mellitus and maternal and neonatal pregnancy data were prospectively collected on outcomes.
In total 1,795 singleton pregnancies (878 women with GDM and 824 NGT women) were analyzed. The risk of LBW and small-for-gestational age in the GDM group was significantly higher than in the NGT group. A similar relationship was found for LBW risk in the non-overweight/obese group but not in the overweight/obese group.
We established a prospective GDM registry system in Japan. In the management of GDM in Japan, suppression of maternal weight gain may be associated with reduced fetal growth, especially in non-overweight/obese women with GDM; however, further investigation is required.
目的/引言：在日本，生育年龄女性体重过轻的频率不断增加，低出生体重（LBW）的比例也随之上升，这是一个社会问题。本研究旨在建立日本妊娠糖尿病（GDM）的前瞻性注册系统，并根据国际妊娠糖尿病研究组（IADPSG）标准阐明 GDM 的实际现状。
从 2015 年 10 月开始，将患有妊娠糖尿病和正常糖耐量（NGT）的孕妇纳入糖尿病和母婴妊娠结局研究。在孕早期和中晚期行葡萄糖筛查阳性的孕妇，在孕 32 周时行 75 g 口服葡萄糖耐量试验。根据 IADPSG 标准诊断妊娠糖尿病。中晚期葡萄糖筛查阳性但 NGT 的孕妇被纳入作为对照（NGT 组）。对妊娠糖尿病的治疗和母婴妊娠数据进行前瞻性收集。
共分析了 1795 例单胎妊娠（878 例 GDM 孕妇和 824 例 NGT 孕妇）。GDM 组的 LBW 和小于胎龄儿的风险明显高于 NGT 组。在非超重/肥胖组中也发现了类似的 LBW 风险关系，但在超重/肥胖组中则没有。
我们在日本建立了一个前瞻性的 GDM 注册系统。在日本的 GDM 管理中，抑制母体体重增加可能与胎儿生长受限有关，特别是在非超重/肥胖的 GDM 妇女中；然而，还需要进一步的研究。
