Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China.
Fujian Obstetrics and Gynecology Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China.
Sci Rep. 2024 Jan 17;14(1):1466. doi: 10.1038/s41598-024-51879-x.
Now, no recommendations of gestational weight gain (GWG) after gestational diabetes mellitus (GDM) diagnosis for Chinese women was made. This study aimed to explore the optimal GWG after oral glucose tolerance test (OGTT) for Chinese women with GDM. The GWG status of 11,570 women was retrospectively analyzed. Binary regression model and restricted cubic spline were used to estimate the association between GWG after OGTT and the predicted probability of adverse outcomes. Based on above, the optimal GWG was defined as the range that not exceed 1% increase in the predicted probability from the lowest point. Results shown that every increased one unit GWG after OGTT was associated with higher risks of macrosomia, cesarean section and LGA, and lower risk of preterm birth. According to the WHO and Working Group on Obesity in China (WGOC) recommended pre-pregnancy BMI category, the optimal GWG were proposed: 3.66 to 6.66 kg/3.66 to 6.66 kg in underweight group, 3.07 to 6.50 kg/3.02 to 6.40 kg in normal weight group, 1.06 to 2.73 kg/0 to 1.99 kg in overweight group, and not applicable/- 0.22 to 2.53 kg in obese group, respectively. Therefore, it is necessary to classified Chinese population based on the WGOC recommended pre-pregnancy BMI category, that influenced the contribution of pre-pregnancy BMI groups and the optimal GWG recommendation for GDM women with overweight or obesity.
目前，对于中国女性，妊娠期糖尿病（GDM）诊断后，并未推荐特定的妊娠体重增加（GWG）。本研究旨在探索 GDM 女性口服葡萄糖耐量试验（OGTT）后最佳 GWG。回顾性分析了 11570 名女性的 GWG 状况。采用二元回归模型和限制三次样条来估计 OGTT 后 GWG 与不良结局预测概率之间的关联。在此基础上，将 GWG 定义为不超过最低点预测概率增加 1%的范围。结果表明，OGTT 后每增加一个单位的 GWG，与巨大儿、剖宫产和巨大儿的风险增加相关，与早产的风险降低相关。根据世界卫生组织（WHO）和中国肥胖工作组（WGOC）推荐的孕前 BMI 类别，提出了最佳 GWG：低体重组为 3.66 至 6.66kg/3.66 至 6.66kg，正常体重组为 3.07 至 6.50kg/3.02 至 6.40kg，超重组为 1.06 至 2.73kg/0 至 1.99kg，肥胖组为不适用/-0.22 至 2.53kg。因此，有必要根据 WGOC 推荐的孕前 BMI 类别对中国人群进行分类，这会影响到孕前 BMI 组的贡献以及超重或肥胖 GDM 女性的最佳 GWG 推荐。
