Department of Public Health, Jigjiga University, Jigjiga, Ethiopia
Department of Epidemiology and Biostatistics, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.
BMJ Open. 2024 Nov 27;14(11):e082539. doi: 10.1136/bmjopen-2023-082539.
Maternal obesity and gestational diabetes mellitus (GDM) are becoming major public health concerns in developing countries. Understanding their relationship can help in developing contextually appropriate and targeted prevention strategies and interventions to improve maternal and infant health outcomes. This study aimed to determine the association of maternal overweight and obesity with GDM among pregnant women in Ethiopia.
Case-control study.
The study was conducted in selected public hospitals in Addis Ababa, Ethiopia, from 10 March to 30 July 2020.
159 pregnant women with GDM (cases) and 477 pregnant women without GDM (controls).
Screening and diagnosis of GDM in pregnant women was done by a physician using the 2013 WHO criteria of 1-hour plasma glucose level of 10.0 mmol/L (180 mg/dL) or 2-hour plasma glucose level of 8.5-11.0 mmol/L (153-199 mg/dL) following a 75 g oral glucose load. Overweight and obesity were measured using mid-upper arm circumference (MUAC). Binary logistic regression with bivariate and multivariable models was done to measure the association of overweight and obesity with GDM. Adjusted ORs (AORs) with a 95% CI were computed, and statistical significance was determined at a value of p=0.05.
GDM was associated with obesity (MUAC≥31) (AOR 2.80; 95% CI 1.58 to 4.90), previous history of caesarean section (AOR 1.91; 95% CI 1.14 to 3.21) and inadequate Minimum Dietary Diversification Score <5 (AOR 3.55; 95% CI 2.15 to 5.86). The AOR for overweight (MUAC≥28 and MUAC<31) was 1.51 (95% CI 0.71 to 3.21). The odds of developing GDM were 72% lower in pregnant women who were engaging in high-level physical activity (AOR 0.28; 95% CI 0.12 to 0.67).
Obesity, but not overweight, was significantly associated with the development of GDM. Screening for GDM is recommended for pregnant women with obesity (MUAC≥31) for targeted intervention. Antenatal care providers should provide information for women of childbearing age on maintaining a healthy body weight before and in-between pregnancies and the need for healthy, diversified food and high-level physical activity.
在发展中国家，母体肥胖和妊娠糖尿病（GDM）正成为主要的公共卫生问题。了解它们之间的关系有助于制定符合国情的、有针对性的预防策略和干预措施，以改善母婴健康结局。本研究旨在确定埃塞俄比亚孕妇中母体超重和肥胖与 GDM 的关系。
病例对照研究。
这项研究于 2020 年 3 月 10 日至 7 月 30 日在埃塞俄比亚亚的斯亚贝巴的选定公立医院进行。
159 名患有 GDM（病例）的孕妇和 477 名未患有 GDM（对照）的孕妇。
通过医生使用 2013 年世卫组织的标准，对孕妇进行 GDM 的筛查和诊断，即 75g 口服葡萄糖负荷后 1 小时血浆葡萄糖水平为 10.0mmol/L（180mg/dL）或 2 小时血浆葡萄糖水平为 8.5-11.0mmol/L（153-199mg/dL）。使用中上臂围（MUAC）来测量超重和肥胖。使用双变量和多变量模型进行二元逻辑回归，以测量超重和肥胖与 GDM 的关系。计算了调整后的比值比（AOR）和 95%置信区间，并以 p=0.05 为界确定统计学意义。
肥胖（MUAC≥31）、既往剖宫产史（AOR 1.91；95%CI 1.14 至 3.21）和最低饮食多样化评分不足 5 分（AOR 3.55；95%CI 2.15 至 5.86）与 GDM 有关。超重（MUAC≥28 且 MUAC<31）的 AOR 为 1.51（95%CI 0.71 至 3.21）。高体力活动水平的孕妇发生 GDM 的几率降低 72%（AOR 0.28；95%CI 0.12 至 0.67）。
肥胖与 GDM 的发生显著相关，但超重与 GDM 的发生无显著相关性。建议对肥胖（MUAC≥31）的孕妇进行 GDM 筛查，以便进行针对性干预。围产期保健提供者应向育龄妇女提供有关在妊娠前和妊娠期间保持健康体重、健康多样化饮食和高水平体力活动的信息。
