孕期体重增加对妊娠期糖尿病的影响

Influence of Pregnancy Weight Gain on Incidence of Gestational Diabetes Mellitus

目的比较孕24周妊娠期糖尿病（GDM）孕妇与正常糖耐量（NGT）孕妇体重增加值，评价孕早中期体重增加值对妊娠期糖尿病发病的影响。方法根据年龄、孕前BMI配对观察126例GDM孕妇和252例NGT孕妇24～26周OGTT检查时体重增长情况，比较不同BMI水平孕妇体重增长值对妊娠期糖尿病发病的影响。结果NGT、GDM组孕24周体重增长值存在显著差异，根据BMI分组后，超重和肥胖组差异有统计学意义（P〈0．05），根据是否应用胰岛素分组，应用胰岛素组与单纯饮食控制组差异无统计学意义（P=0．673）。结论至妊娠24周体重增长较快的孕妇更易发展成妊娠期糖尿病。孕早中期体重增长过快是孕前肥胖、超重的孕妇发生GDM的独立危险因素。

Objective To compare the weight gain at 23 - 26 weeks＇ gestation between pregnant woman with gestational dia- betes mellitus （GDM） and pregnant woman with and normal glucose tolerance （NGT） , and evaluate the influence of the weight gain on the incidence of gestational diabetes in the early or middle stage of gestation. Methods Total 126 pregnant women with GDM and 252 pregnant women with NGT was matching observed according to the age and body mass index （ BMI）, the weight gain at 24 - 26 weeks＇ gestation was recorded when the oral glucose tolerance tests （OGTr） was performed. Results Weight gain in GDM group was significantly higher than that in NGT group at 24 -26 weeks＇ gestation（P 〈0.01 ）. In GDM group,the weight gain increased differently between overweight and obese pregnant women （ P = O. 008, P = 0. 006 ）. The difference in the weight gain between pregnant women receiving insulin and those receiving diet control treatment was not significant（ P = 0.673 ）. Conclusion Pregnant women with a higher gestational weight gain at 23 -26 weeks＇ gestation are more likely to develop into GDM. Gestational weight gain is a independent risk factor on GDM in the overweight and obese pregnant women.