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孕前体重增加与妊娠期糖尿病风险增加相关。

Pregravid Weight Gain Is Associated with an Increased Risk of Gestational Diabetes.

作者信息

Kim Sunmie, Han Kyungdo, Choi Su-Yeon, Kim Min Joo, Yang Sun Young, Choi Seung Ho, Yim Jeong Yoon, Kim Jin Ju, Kim Min-Jeong

机构信息

Department of Obstetrics and Gynecology, Seoul National University Hospital Healthcare System Gangnam Center, Seoul National University College of Medicine, Seoul, Korea.

Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea.

出版信息

Diabetes Metab J. 2025 Jul;49(4):826-836. doi: 10.4093/dmj.2024.0491. Epub 2025 Mar 26.

Abstract

BACKGRUOUND

Studies have reported a significant association between pregravid weight gain and the subsequent development of gestational diabetes mellitus (GDM) in various populations. The current study aims to investigate this relationship using data from the Korean National Health Insurance Service database.

METHODS

We conducted a retrospective nationwide population-based cohort study, involving 159,798 women who gave birth between 2015 and 2017 and had undergone two national health screening examinations: 1 year (index checkup) and 3 years before (baseline checkup) their respective estimated conception date. Participants were categorized into five groups based on the extent of weight change between the two examinations: more than 10%, 5% to 10%, -5% to 5% (reference group), -10% to -5%, and more than -10%. The study assessed the association between pregravid weight change and GDM risk.

RESULTS

Among the 146,363 women analyzed, 11,012 (7.52%) were diagnosed with GDM. Multiple regression analysis revealed that women who gained 5% to 10% of their weight had a 12% increased risk of GDM (adjusted odds ratio [aOR], 1.12; 95% confidence interval [CI], 1.06 to 1.17), while those who gained ≥10% had a 34% higher risk (aOR, 1.34; 95% CI, 1.26 to 1.43). Notably, pregravid weight gain was particularly associated with GDM risk in non-obese or non-metabolic syndrome groups at index checkup.

CONCLUSION

Pregravid weight gain showed a dose-dependent association with a higher risk of GDM. This association was more pronounced in non-obese individuals emphasizing the importance of minimizing pregravid weight gain for GDM prevention, even in non-obese women.

摘要

背景

研究报告称,在不同人群中,孕前体重增加与随后发生的妊娠期糖尿病(GDM)之间存在显著关联。本研究旨在利用韩国国民健康保险服务数据库中的数据调查这种关系。

方法

我们进行了一项基于全国人群的回顾性队列研究,纳入了2015年至2017年间分娩且在各自预计受孕日期前1年(指数检查)和3年(基线检查)接受过两次全国健康筛查的159,798名女性。根据两次检查之间体重变化的程度,将参与者分为五组:体重增加超过10%、增加5%至10%、-5%至5%(参照组)、-10%至-5%以及减少超过10%。该研究评估了孕前体重变化与GDM风险之间的关联。

结果

在分析的146,363名女性中,11,012名(7.52%)被诊断为GDM。多元回归分析显示,体重增加5%至10%的女性患GDM的风险增加了12%(调整后的优势比[aOR]为1.12;95%置信区间[CI]为1.06至1.17),而体重增加≥10%的女性风险则高34%(aOR为1.34;95%CI为1.26至1.43)。值得注意的是,在指数检查时,孕前体重增加与非肥胖或非代谢综合征组的GDM风险尤其相关。

结论

孕前体重增加与GDM风险呈剂量依赖性关联。这种关联在非肥胖个体中更为明显,强调了即使在非肥胖女性中,尽量减少孕前体重增加对预防GDM的重要性。

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