GDM患者妊娠期BMI增速与新生儿出生体重的相关性分析

Correlation between BMI growth rateduring pregnancy and neonatal birth weight in patients with GDM

目的探究妊娠期糖尿病(GDM)患者不同妊娠时期身体质量指数(BMI)增加与糖脂代谢指标及新生儿出生体重的相关性。方法选取2017年2月至2018年2月于永康市妇幼保健院进行产检和分娩并确诊为GDM的孕妇110例作为观察组,同时选取同期健康孕妇50例作为对照组,回顾性分析两组孕妇的临床资料。对比两组孕妇不同妊娠时期体重增长情况和糖脂代谢指标,对比两组新生儿出生体重,并分析不同妊娠时期BMI增加与糖脂代谢和新生儿出生体重的相关性。结果观察组孕13~26+6周与孕33周至分娩前BMI增速明显高于对照组(t值分别为9.261、6.411,均P<0.001)。观察组孕妇分娩前空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白胆固醇(LDL-C)水平均明显高于对照组(t值分别为5.067、4.193、8.271、8.893、4.943,均P<0.001),而新生儿出生体重明显高于对照组(t=5.573,P<0.001)。GDM患者任何妊娠时期BMI增速与FPG呈正相关(r分别为0.623、0.487、0.635,均P<0.05),孕13~26+6周与孕33周至分娩前BMI增速与HbA1c、TC、TG、LDL-C及新生儿出生体重呈正相关(r分别为0.524、0.617、0.542、0.578、0.568、0.552、0.562、0.614,均P<0.05)。结论孕13~26+6周与孕33周至分娩前BMI增速与糖脂代谢及新生儿出生体重呈正相关,提示孕13~26+6周与孕33周至分娩前BMI增速过快可能会导致孕妇糖脂代谢紊乱,从而使新生儿出生体重增加。

Objective To investigate the correlation of body mass index(BMI)increase in patients with gestational diabetes mellitus(GDM)during different periods of pregnancy with glucose and lipid metabolism indexes and neonatal birth weight.Methods 110 pregnant women with GDM who received antenatal care and delivered in Yongkang Maternal and Child Health Care Hospital during the period from February 2017 to February 2018 were selected as the observation group.At the same time,50 healthy pregnant women were selected as controls.The clinical data of all pregnant women were retrospectively analyzed.Weight gain during different periods of pregnancy,glucose and lipid metabolism indexes and neonatal birth weight were compared between the two groups.The correlation of BMI increase during different periods of pregnancy with glucose and lipid metabolism and neonatal birth weight was analyzed.Results The increase of BMI in the observation group from 13~26+6 weeks and 33 weeks to the time before delivery was significantly greater than that in the control group(t=9.261,6.411,P<0.001).Levels of FPG,HbA1 c,TC,TG and LDL-C in the observation group before delivery were higher than those in the control group(t=5.067,4.193,8.271,8.893,and 4.943 respectively,P<0.001),and the neonatal birth weight was significantly heavier than that in the control group(t=5.573,P<0.001).The BMI increase of patients with GDM during any period of pregnancy was positively correlated with FPG(r=0.623,0.487,0.635).The increase of BMI from 13~26+6 weeks and 33 weeks to the time before delivery was positively correlated with HbA1 c,TC,TG,LDL-C and neonatal BMI(r=0.524,0.617,0.542,0.578,0.568,0.552,0.562,0.614).Conclusion The increase of BMI from 13~26+6 weeks and 33 weeks to the time before delivery is positively correlated with glucose and lipid metabolism and neonatal birth weight,suggesting that the rapid growth of BMI from 13~26+6 weeks and 33 weeks to the time before delivery may result in disorders of glucose and lipid metabolism in pregnant women,thus increasing neonatal birth weight.