妊娠期糖尿病不同孕前体重指数与母婴结局的关系

Relationship between body mass index before pregnancy and maternal and neonatal outcomes in gestational diabetes mellitus

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)孕产妇孕前体重指数(BMI)与母婴结局的关系,以期提供孕前体重管理的相关依据。方法回顾性分析194例经产前门诊常规检查确诊为GDM的初孕妇临床资料,根据BMI指数分为轻体质组57例、正常组87例和超重肥胖组50例,比较各组的母婴结局。结果不同BMI指数孕妇的平均年龄、平均孕周和文化程度差异均无统计学意义(P>0.05),但产程异常率、剖宫产率、产后出血率、新生儿体重、巨大儿发生率和新生儿窒息率在轻体质组、正常组和超重肥胖组之间差异具有统计学意义(P<0.05),且超重肥胖组上述观察指标均高于轻体质组和正常组。结论 GDM孕产妇孕前体重指数与母婴结局有关,控制体重指数在正常范围内利于改善妊娠结局。

Objective To investigate the relationship between body mass index（ BMI） before pregnancy and maternal and neonatal outcomes in gestational diabetes mellitus（ GDM） so as to provide the basis for pre-pregnancy weight management.Methods The clinical data of 194 pregnant women with GDM were retrospectively analyzed. According to the BMI index,the subjects were divided into three groups,namely,light weight group（ n = 57）,normal group（ n = 87）,and overweight group（ n = 50）. The maternal and neonatal outcomes of each group were compared. Results The average age,average gestational age and educational level of pregnant women with different BMI index had no significant difference（ P〉0.05）.However,the abnormal rate of labor,cesarean section rate,postpartum hemorrhage rate,neonatal body weight,incidence of macrosomia and neonatal asphyxia had a statistically significant difference among the three groups（ P〈0.05）. The above indexes in overweight group were higher than those in light weight group and normal group. Conclusions The body mass index before pregnancy of the pregnant women with GDM is related to maternal and neonatal outcomes. Controlling body mass index in normal range is beneficial to improving pregnancy outcome.