孕前肥胖及孕期体重增长过度与妊娠期糖尿病关系探讨

Exploration of relationship between pre-pregnancy obesity and excessive weight gain during pregnancy and gestational diabetes

目的探讨孕前期肥胖以及孕期体重增长过度与妊娠期糖尿病的关系。方法选择2010年7月~2012年3月在笔者所在医院定期产前检查并分娩的孕妇1998名,于24～28w做50g葡萄糖激发试验,进行GDM的筛查,对筛查结果阳性者再做75g葡萄糖耐量试验;由专人测量并且记录孕妇孕前的身高、体重和腰围,计算体重指数和整个孕期体重增加值。结果肥胖组（BMI≥24）与非肥胖组（BMI〈24）GDM的发生率差异有统计学意义（P〈0.01）。孕期体重增长过度组GDM的发生率显著高于体重增长正常组（P〈0.01）。结论孕前肥胖以及孕期体重增长过度均与妊娠期糖尿病的发生有关,适度的减轻孕前体重和孕期体重适度增加可能减少妊娠期糖尿病的发生,提高孕期质量。

Objective To investigate the relationship between the pre-pregnancy obesity and excessive weight gain during pregnancy and the gestational diabetes. Methods A total of 1998 pregnant women receiving regular antenatal examination and delivered in our hospital from July 2010 to March 2012 were selected to receive the 50 g glucose challenge test and the gestational diabetes mellitus screening. The pregnant women with positive results received 75 g oral glucose tolerance test. Specially-assigned persons were in charge of measuring and recording the pre-pregnant height, weight and waist circumference and calculating the body mass index and value of weight gain during pregnancy. Results The obese group （BMI ≥ 24） and the non-obese group （BMI 24） were significantly different in the GDM incidence （P 0.01）. The excessive weight gain during pregnancy group was significantly higher than the normal weight gain group in the GDM incidence （P 0.01）. Conclusion Pre-pregnant obesity and excessive weight gain during pregnancy are both associated with the occurrence of gestational diabetes,therefore appropriate loss of pre- pregnant weight and appropriate gaining of weight during pregnancy can reduce the incidence of gestational diabetes and improve the pregnancy quality.