孕妇体成分在不同孕周的变化及与妊娠期糖尿病的相关性

Changes in maternal body composition at different gestational weeks and their correlation with gestational diabetes mellitus

目的比较不同孕周孕妇体成分的变化情况及与妊娠期糖尿病的关系。方法应用生物电阻抗方法,对2017年3月~2018年3月在我院门诊定期产检孕妇547例,分别在孕前期(孕8周内)、孕早期(孕12~14周)、孕中期(20~24周)、孕晚期(28~32周)、分娩前(36周后)进行人体成分测试,观察并记录孕妇总体水、体脂指数、体脂率、去脂指数、体质指数、腰臀比及基础代谢率。孕中期行糖耐量试验并记录结果。结果发现孕妇体成分各个指标随孕周的增长而增加(PTBW、BFM、FFM、BMI、PBF、BMR<0.001),但晚孕期与分娩前无明显差异(PBFM、BMI、PBF、WHR>0.05)。孕前BMI升高与GDM的发病较孕期更有意义(P=0.014)。结论妊娠期孕妇的体成分变化显著,至分娩前趋于稳定。孕前控制体质指数更有利于控制妊娠期糖尿病的发生。

Objective To compare the changes in maternal body composition at different gestational weeks and their relationship with gestational diabetes mellitus.Methods Using the bioelectrical impedance method,547 pregnant women who underwent regular antenatal examination in the Outpatient Department of our hospital from March 2017 to March2018 were tested for body composition during the pre-pregnancy period(within 8 weeks),the first trimester(12 to 14 weeks),the second trimester(20 to 24 weeks),the third trimester(28 to 32 weeks),and before delivery(after 36 weeks).The total amniotic fluid,body fat index,body fat rate,fat-free index,body mass index,waist-hip ratio,and basal metabolic rate of pregnant women were observed and recorded.Glucose tolerance tests were performed in the second trimester and the results were recorded.Results It was found that each index of maternal body composition increased with the increase of gestational week(PTBW,BFM,FFM,BMI,PBF,BMR<0.001),but there was no significant difference between the third trimester and before delivery(PBFM,BMI,PBF,WHR>0.05).Increased BMI before pregnancy and the incidence of GDM were more significant than those during pregnancy(P=0.014).Conclusion The changes in body composition of pregnant women during pregnancy are significant and tended to be stable before delivery.Controlling body mass index before pregnancy is more beneficial to control the occurrence of gestational diabetes mellitus.