Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Section of Epidemiology and Population Health & Department of Obstetrics and Gynecology, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, West China Second University Hospital, Sichuan University, Chengdu, China.
Am J Clin Nutr. 2023 Jun;117(6):1353-1361. doi: 10.1016/j.ajcnut.2023.04.016. Epub 2023 Apr 15.
Evidence regarding prepregnancy weight change and gestational diabetes mellitus (GDM) is lacking among East Asian women.
Our study aimed to investigate the association between weight change from age 18 y to pregnancy and GDM in Chinese pregnant women.
Our analyses included 6972 pregnant women from the Tongji-Shuangliu Birth Cohort. Body weights were recalled for age 18 y and the time point immediately before pregnancy, whereas height was measured during early pregnancy. Prepregnancy weight change was calculated as the difference between weight immediately before pregnancy and weight at age 18 y. GDM outcomes were ascertained by 75-g oral-glucose-tolerance test. Multivariable logistic regression models were used to examine the association between prepregnancy weight change and risk of GDM.
In total, 501 (7.2%) developed GDM in the cohort. After multivariable adjustments, prepregnancy weight change was linearly associated with a higher risk of GDM (P < 0.001). Compared with participants with stable weight (weight change within 5.0 kg) before pregnancy, multivariable-adjusted odds ratios and 95% confidence intervals were 1.55 (1.22, 1.98) and 2.24 (1.78, 2.83) for participants with moderate (5-9.9 kg) and high (≥10 kg) weight gain, respectively. In addition, overweight/obesity immediately before pregnancy mediated 17.6% and 31.7% of the associations of moderate and high-weight gain with GDM risk, whereas weekly weight gain during pregnancy mediated 21.1% and 22.7% of the associations.
Weight gain from age 18 y to pregnancy was significantly associated with a higher risk of GDM. Maintaining weight stability, especially prevention of excessive weight gain from early adulthood to pregnancy, could be a potential strategy to reduce GDM risk.
东亚女性妊娠糖尿病（GDM）相关的孕前体重变化证据不足。
本研究旨在探讨中国孕妇从 18 岁到妊娠期间体重变化与 GDM 的关系。
我们的分析包括来自同济-双流出生队列的 6972 名孕妇。18 岁时和怀孕前的体重被回忆，而身高在孕早期测量。孕前体重变化是用怀孕前的体重减去 18 岁时的体重来计算的。GDM 的结果通过 75 g 口服葡萄糖耐量试验来确定。多变量逻辑回归模型用于检查孕前体重变化与 GDM 风险之间的关系。
在队列中，共有 501 人（7.2%）发生 GDM。经多变量调整后，孕前体重变化与 GDM 风险呈线性相关（P < 0.001）。与怀孕前体重稳定（体重变化在 5.0 公斤以内）的参与者相比，多变量调整后的比值比和 95%置信区间分别为 1.55（1.22，1.98）和 2.24（1.78，2.83），体重适度增加（5-9.9 公斤）和体重增加过高（≥10 公斤）。此外，怀孕前超重/肥胖立即解释了中度和高度体重增加与 GDM 风险之间关系的 17.6%和 31.7%，而怀孕期间每周体重增加解释了 21.1%和 22.7%。
从 18 岁到妊娠期间的体重增加与 GDM 风险显著相关。保持体重稳定，特别是预防从成年早期到妊娠期间的体重过度增加，可能是降低 GDM 风险的一种潜在策略。
