妊娠期糖尿病和孕期肥胖的风险关系分析

Relationship between gestational diabetes mellitus and obesity during pregnancy

目的旨在探讨妊娠期糖尿病(GDM)与孕期肥胖的风险关系。方法选取2017年1月至2018年5月在浙江普陀医院门诊就诊的妊娠期妇女618例,收集其临床资料及孕期资料,并进行详细的记录。评估病例组(患GDM)和非病例组的肥胖指标特征,分析孕前身体质量指数(BMI)及孕期体重增长范围与GDM的关系。结果病例组和非病例组的孕前BMI分别为(23.51±2.46)kg/m2和(20.41±2.16)kg/m2,比较差异有统计学意义(t=6.433,P<0.05);孕前腰围分别为(74.84±4.61)cm和(69.12±4.25)cm,比较差异有统计学意义(t=6.045,P<0.05)。孕前BMI<25kg/m2和≥25kg/m2的患者分别有580例和38例,其GDM的发病率分别为2.24%和21.05%,比较差异有统计学意义(χ2=38.445,P<0.05)。妊娠期体重增加小于标准范围的妊娠期妇女均未发现GDM;在标准体重增长范围的妊娠期妇女,GDM发生率为1.29%;超过标准体重增长范围的妊娠期妇女,GDM发生率为4.94%,超过标准体重增长范围者GDM发生率明显高于在标准体重增长范围者(χ2=4.567,P<0.05)。结论妊娠期糖尿病与孕期肥胖有一定的关系,孕前BMI过高、腰围过大及孕期体重增长范围过大均可能增加GDM的发病风险。

Objective To investigate the relationship between gestational diabetes mellitus（GDM）and obesity during pregnancy.Methods From January 2017 to May 2018 atotal of 618 pregnant woman visiting People＇s Hospital of Putuo were selected,and their clinical data and pregnancy data were collected and recorded in details.Characteristics of obesity indicators in case group（GDM group）and non-case group were evaluated to assess the correlation of pre-pregnancy BMI and gestational weight gain with GDM.Results The pre-pregnancy BMI was 23.51±2.46 kg/m^2 and 20.41±2.16 kg/m^2 in the case group and the non-case group,respectively,and the difference was statistically significant（t=6.433,P〈0.05）.Pre-pregnancy waist circumference was 74.84±4.61 cm and 69.12±4.25 cm,respectively,and the difference was statistically significant（t=6.045,P〈0.05）.There were 580 cases and 38 cases with pre-pregnancy BMI〈25 kg/m^2 and≥25 kg/m^2,respectively,and the incidence of GDM was 2.24% and21.05%,respectively.The differences between them were statistically significant（χ2=38.45,P〈0.05）.GDM was not found in cases whose gestational weight gain was lower than standard range.The incidence of GDM was 1.29% among cases whose gestational weight gain was in standard range and that was 4.94% among cases whose gestational weight gain exceeded standard range.The incidence of GDM in cases over the standard weight growth range was significantly higher than that in cases in standard weight growth range（χ2=4.567,P 0.05）.Conclusion There is a certain relationship between GDM and obesity during pregnancy,and it is found that high pre-pregnancy BMI,large waist circumference and excessive weight gain during pregnancy may increase the risk of GDM.