Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Obstetric Medicine, Osaka Women's and Children's Hospital, Izumi, Japan.
J Diabetes Investig. 2024 Jul;15(7):906-913. doi: 10.1111/jdi.14177. Epub 2024 Mar 6.
AIMS/INTRODUCTION: In 2021, the guidelines on gestational weight gain (GWG) were revised and increased by 2-3 kg in Japan. This study aimed to investigate whether the revised guidelines would increase the incidence of babies with excessive birth weight in mothers with diabetes.
This retrospective study included 369 deliveries of women with diabetes whose pre-pregnancy body mass index was below 30 kg/m between 1982 and 2021. The primary outcome measure was large for gestational age (LGA). We compared the incidence of LGA between women who gained weight within the previous guidelines and women who gained weight within the revised guidelines. We also compared the incidence of macrosomia, preeclampsia, small for gestational age (SGA), and low birth weight.
The incidence of LGA was not significantly different between women who gained weight within the revised guidelines and those within the previous guidelines (34.6% [95% confidence interval 25.6-44.6%] for the revised guidelines vs 28.9% [21.6-37.1%] for the previous guidelines; P = 0.246). Neither was the incidence of macrosomia or preeclampsia significantly different (8.7% [4.0-15.8%] vs 5.6% [2.5-10.8%] and 5.8% [2.1-12.1%] vs 6.3% [2.9-11.7%]; P = 0.264 and 0.824, respectively), while women who gained weight within the revised guidelines had a lower incidence of SGA (1.9% [0.2-6.8%] vs 10.6% [6.0-16.8%]; P = 0.001) and low birth weight (1.0% [0.02-5.2%] vs 7.0% [3.4-12.6%]; P = 0.023).
The revised GWG guidelines could be beneficial in women with diabetes in terms of delivering babies with appropriate birth weight.
目的/引言：2021 年，日本修订并增加了妊娠体重增加（GWG）指南，增加了 2-3kg。本研究旨在探讨修订后的指南是否会增加糖尿病母亲所生婴儿体重过大的发生率。
这是一项回顾性研究，纳入了 1982 年至 2021 年间 369 名患有糖尿病且孕前体重指数低于 30kg/m²的女性分娩。主要结局指标为巨大儿（LGA）。我们比较了体重增加符合旧指南和新指南的女性中 LGA 的发生率。我们还比较了巨大儿、子痫前期、小于胎龄儿（SGA）和低出生体重的发生率。
体重增加符合新指南和旧指南的女性中 LGA 的发生率无显著差异（新指南为 34.6%[25.6-44.6%]，旧指南为 28.9%[21.6-37.1%]；P=0.246）。巨大儿或子痫前期的发生率也无显著差异（8.7%[4.0-15.8%] vs 5.6%[2.5-10.8%] 和 5.8%[2.1-12.1%] vs 6.3%[2.9-11.7%]；P=0.264 和 0.824），而体重增加符合新指南的女性 SGA（1.9%[0.2-6.8%]）和低出生体重（1.0%[0.02-5.2%]）的发生率较低（10.6%[6.0-16.8%] 和 7.0%[3.4-12.6%]；P=0.001 和 0.023）。
修订后的 GWG 指南可能有益于糖尿病女性，有助于分娩出体重适宜的婴儿。
