妊娠期糖尿病孕妇体重指数与围产结局的关系

The correlation of body mass index of gestational diabetes mellitus women in pregnancy to the perinatal outcome

目的观察妊娠期糖尿病孕妇体重指数(BMI)对围产结局的影响。方法合并妊娠期糖尿病孕妇149例,依照BMI范围分为正常组(18.5≤BMI<25)、过重组(25≤BMI<28)及肥胖组(28≤BMI<32);比较各组一般资料、BMI、空腹血糖及围产结局的差异性,分析BMI对不良围产结局的预测价值。结果各组孕产妇的妊娠次数、生产次数、流产情况及孕周等一般资料差异无统计学意义(P>0.05);子痫前期发生率的组间差异无统计学意义(P>0.05),羊水过多、胎膜早破、胎儿窘迫及早产的组间差异均有统计学意义(P<0.05);妊娠期间,各组患者血糖值差异有统计学意义(P<0.05)。简单线性回归分析表明,入院时、妊娠中晚期的血糖值和BMI均呈正相关性(R2=0.3996、0.443、0.4914,均P<0.05)。本组新生儿的主要并发症为巨大儿、新生儿窒息、低血糖、高胆红素及湿肺,各项并发症的组间差异均有统计学意义(P<0.05)。结论妊娠期糖尿病孕产妇BMI水平与血糖成正相关,对孕期并发症有重要影响,能够从一定程度上预测不良围产结局。

Objective To understand the possible correlation of body mass index（ BMI） to the perinatal outcome in cases of gestational diabetes mellitus. Method 149 patients with gestational diabetes mellitus were divided into 3 groups according to their BMI,namely,the control group（ 18. 5≤BMI 25）,the heavy group（ 25≤BMI 28） and the obesity group（ 28≤BMI 32 =. The clinical data,BMI,fasting blood glucose and perinatal outcomes were compared to analyze the predictive value of BMI to poor perinatal outcomes of patients. Findings There was no significant difference in pregnancy times,production times,abortion and gestational age between the three groups（ P〉0. 05）. In terms of pregnancy complications,there was no significant difference in the incidence of preeclampsia between the groups（ P〉0. 05）,but not in hydramnios,premature rupture of membrane,fetal distress and premature birth（ P〈0. 05 =. During pregnancy,there was difference in blood glucose levels and BMI between the groups（ P〈0. 05）. Simple linear regression analysis showed that the blood glucose levels of patients was positively correlated with BMI（ R^2= 0. 3996,0. 443,0. 4914,P〈0. 05 =. The main complication of the neonates were macrosomia,neonatal asphyxia and low blood sugar,high bilirubin and wet lung. There was significant difference between the groups in these aspects（ P〈0. 05 =. Conclusion The BMI level of gestational diabetes mother is closely related to fasting blood glucose levels,which has important influence on pregnancy complications and can be used to estimate poor perinatal outcome.