孕前体质指数及妊娠期体重增长与妊娠期糖尿病及高血压的关系

Relationship of prepregnancy body mass index and gestational weight gain with gestational diabetes and gestafional hypertension

目的研究孕前体质指数（pBMI）及妊娠期体重增长（GWG）与产妇患妊娠期糖尿病及高血压的关系。方法回顾性分析2011年2月至2012年2月行常规产前检查并住院分娩的产妇1240例，记录pBMI、GWG、第24—28孕周的空腹血糖及血压水平。采用相关性分析及Logistic回归分析的方法研究pBMI及GWG与妊娠期糖尿病及高血压的关系。结果根据pBMI分组，轻体重组260例，正常体重组917例，超重组36例，肥胖组27例。根据GWG分组，低度增长组104例，正常增长组758例，中度增长组249例，高度增长组129例。pBMI与GWG呈负相关（r=-0．646，P〈O．01）。以正常体重组为参照，超重组妊娠期糖尿病发病率为11．11％（4／36），OR值为4．120，｜P〈0．05；肥胖组妊娠期糖尿病发病率为18．52％（5，27），OR值为7．492，P〈0．05；肥胖组妊娠期高血压发病率为11.11％（3／27），OR值为6．243，P〈0．05。以正常增长组为参照，低度增长组妊娠期糖尿病发病率为15．38％（16／104），OR值为9．006，p〈0．05；低度增长组妊娠期高血压发病率为4．81％（5，104），OR值为3．140，P〈0．05；高度增长组妊娠期高血压发病率为4．65％（6，129），OR值为3．033，P〈0．05。各组空腹血糖及血压水平比较差异无统计学意义（P〉0．05）。结论pBMI与GWG呈负相关，pBMI偏高及GWG偏低均是患妊娠期糖尿病及高血压的危险因素。

Objective To study the relationship of prepregnancy body mass index （pBMI） and gestational weight gain （GWG） with gestational diabetes and gestational hypertension. Methods A total of 1240 women having performed routine prenatal care and maternal hospital delivery from February 2011 to February 2012 were enrolled, and pBMI, GWG, fasting plasma glucose and blood pressure at 24 to 28 weeks＇ gestation were recorded. Correlation analysis and Logistic regression analysis were used to study the associations. Results According to pBMI, light body weight group had 260 cases, normal body weight group had 917 cases, overweight group had 36 cases, obesity group had 27 cases. According to GWG, low gain group had 104 cases, normal gain group had 758 cases, middle gain group had 249 cases, high gain group had 129 cases. The correlation analysis showed that pBMI was negatively associated with GWG （r = -0.646,P 〈 0.01）. Compared with that of normal body weight group, the incidence of gestational diabetes was 11.11%（4/36） in overweight group, OR =4.120,P〈 0.05; and 18.52%（5/27） in obesity group,OR = 7.492, P 〈 0.05, and the incidence of gestational hypertension was 11.11% （3/27）, OR = 6.243, P 〈 0.05. Compared with that of normal gain group, the incidence of gestational diabetes was 15.38%（16/104） in low gain group, OR = 9.006, P 〈 0.05, the incidence of gestational hypertension was 4.81% （5/104） in low gain group, OR = 3.140, P 〈 0.05, and the incidence of gestational hypertension was 4.65 % （6/129 ） in high gain group, OR = 3.033, P 〈 0.05. No significant differences were observed in or between groups in fasting plasma glucose and blood pressure（P 〉 0.05 ）. Conclusion It shows that pBMI is negatively associated with GWG, and high pBMI and low GWG is strongly related with gestational diabetes and gestational hypertension.