妊娠不同时期体重增长与妊娠期糖尿病关系研究

Study on the Relationship between Weight Gain and Gestational Diabetes Mellitus during Different Periods of Pregnancy

目的探讨孕妇在妊娠不同时期体重增长(增重)与妊娠期糖尿病(GDM)的关系。方法选取在2016年5月-2018年5月期间来我院初诊确定为妊娠的健康孕妇341例为研究对象。根据是否发生GDM,分为GDM组63例和非GDM组278例。比较2组孕妇妊娠不同时期的增重情况,妊娠不同时期增重与GDM的关系采用Logistic多因素回归分析。结果 2组孕妇在孕早期锻炼、文化程度、家庭人均收入、产次、孕早期及孕中期的饮食能量摄入比较差异无统计学意义(P>0.05)。2组孕前体重指数(BMI)、生育年龄方面差异有统计学意义(P<0.05)。GDM组孕晚期饮食能量摄入显著低于非GDM组(P<0.05)。2组孕妇孕中期增重、孕期总增重情况差异有统计学意义(P<0.05)。孕前BMI、生育年龄、孕中期增重、孕期总增重是孕妇发生GDM的独立危险因素(P<0.05,P<0.01)。结论孕中期增重和孕期总增重是GDM发生的独立危险因素,应该加强对孕中期和孕期体重增重的控制,降低GDM的发生率。

Objective To explore the relationship between weight gain and gestational diabetes mellitus(GDM) in pregnant women during different periods of pregnancy. Methods A total of 341 healthy pregnant women who were diagnosed in our hospital from May 2016 to May 2018 were enrolled. According to presence or absence of GDM, they were divided into GDM group(n=63) and non-GDM group(n=278). Weight gain of pregnant women during different periods of pregnancy was compared, and Logistic multivariate regression analysis was used to analyze the relationship between weight gain and GDM during different periods of pregnancy. Results There was no significant difference in exercise in the first trimester of pregnancy, education, family income per capita, and dietary energy intake in early pregnancy and the second trimester between the two groups(P>0.05). However, the difference in body mass index(BMI) and reproductive age between the two groups was significant(P<0.05). The dietary energy intake during the third trimester in the GDM group was significantly lower than that in the non-GDM group(P<0.05). There was significant difference in weight gain between the two groups in the second and third trimester(P<0.05). Pre-pregnancy BMI, reproductive age, mid-pregnancy weight gain, and total weight gain during pregnancy were independent risk factors for GDM in pregnant women(P<0.05, P<0.01). Conclusion The weight gain in the second trimester and the total weight gain during pregnancy are independent risk factors for GDM. Therefore, the control of weight gain in the second trimester and during pregnancy should be strengthened to reduce the incidence of GDM.