Department of Internal Medicine, The Fourth Hospital of Shijiazhuang, Key Laboratory of Maternal and Fetal Medicine of Hebei Provincial, Shijiazhuang, China.
Front Public Health. 2023 Mar 7;10:1051582. doi: 10.3389/fpubh.2022.1051582. eCollection 2022.
This study investigated the effects of attending a one-day outpatient service on the outcomes of patients with gestational diabetes mellitus (GDM) and different pre-pregnancy body mass indices (BMIs).
The study recruited 311 pregnant women with GDM into a one-day outpatient service at The Fourth Hospital of Shijiazhuang from September 2019 to December 2021. They were randomly assigned to three groups, based on their pre-pregnancy BMI as follows: group A, BMI < 18.5 kg/m; group B, 18.5 ≥ BMI > 25.0 kg/m; group C, BMI ≥25 kg/m. The following information was collected from all the participants: fasting blood glucose, hemoglobin A1c (HbA1C), insulin dose, gestational weight gain, weight gain after the one-day outpatient service, and perinatal outcomes.
The three groups showed significant differences in fasting blood glucose and HbA1C, insulin treatment rate, and the incidence of pregnancy hypertension/preeclampsia and neonatal jaundice (all < 0.05). The rate of excessive gestational weight gain in all of the groups also reflected significant differences ( < 0.05). Group A showed the lowest weight gain, while group C gained the most weight. There is no significant difference in the incidences of hypertension/preeclampsia, neonatal jaundice, or premature birth between patients with weight loss/no weight gain and those with positive weight gain.
One-day diabetes outpatient integrated management may effectively help to manage weight gain and blood glucose in patients with GDM and different pre-pregnancy BMIs. Dietary control after a GDM diagnosis may have helped to avoid weight gain entirely, as well as negative weight gain, but did not increase the risk of maternal and infant-related complications.
本研究旨在探讨参加一日门诊服务对不同孕前体质量指数(BMI)的妊娠期糖尿病(GDM)患者结局的影响。
本研究于 2019 年 9 月至 2021 年 12 月在石家庄市第四医院招募了 311 名 GDM 孕妇参加一日门诊服务。根据其孕前 BMI 将其随机分为三组:A 组,BMI<18.5kg/m;B 组,18.5≥BMI>25.0kg/m;C 组,BMI≥25kg/m。所有参与者均收集以下信息:空腹血糖、糖化血红蛋白(HbA1c)、胰岛素剂量、妊娠期体重增加、一日门诊服务后体重增加以及围产儿结局。
三组在空腹血糖和 HbA1c、胰岛素治疗率以及妊娠高血压/子痫前期和新生儿黄疸的发生率方面均存在显著差异(均<0.05)。所有组的过度妊娠期体重增加率也存在显著差异(均<0.05)。A 组体重增加最少,而 C 组体重增加最多。体重减轻/无体重增加与体重正增加的患者在高血压/子痫前期、新生儿黄疸或早产的发生率方面无显著差异。
一日糖尿病门诊综合管理可能有助于有效管理 GDM 患者不同孕前 BMI 的体重增加和血糖。在诊断 GDM 后进行饮食控制可能有助于完全避免体重增加和负性体重增加,但不会增加母婴相关并发症的风险。