妊娠期体重增加与妊娠期糖尿病的相关性研究

Study on the correlation between body weight gain during pregnancy and gestational diabetes mellitus

目的:妊娠期体重增加与妊娠期糖尿病的相关性以及其对妊娠结局的影响。方法:通过对622例产检孕妇进行问卷跟踪调查,收集孕产妇的一般人口学信息、孕产史、孕期体重(孕早、中、晚3个时期)、血糖值、血压值及分娩期情况,回收有效问卷542份,按GDM诊断标准分为正常组(191例)和GDM组(351例)。结果:两组孕妇以汉族占绝大多数,分别占98.4%和96.0%。GDM组孕前BMI高于正常组(P=0.027),GDM组受教育程度高于正常组(P=0.002),子痫前期和妊娠期高血压发病率均较低。将孕前体重按正常、超重和肥胖进行分组,在孕前体重正常组中孕期前半段每周体重增加与患GDM的风险具有相关性(P<0.05),孕期增重太多会增加剖宫产率,而未发现孕期增重对婴儿出生体重有影响。结论:孕妇应合理增加体重,使妊娠期体重增加在科学范围内。

Objective: To explore the correlation between body weight gain during pregnancy and gestational diabetes mellitus( GDM) and the impact on pregnancy outcome. Methods: A total of 622 pregnant women were followed up and surveyed by a questionnaire,the general demographic information,pregnancy history,body weights during pregnancy( the first,the second and the third trimesters of pregnancy),blood glucose level,blood pressure and delivery condition werecollected; 542 valid questionnaires were retrieved,all the pregnant women were divided into normotension group( 191 patients) and GDM group( 351 patients) according to the diagnostic criteria of GDM. Results: The proportions of pregnant women of Han nationality in the two groups were 98. 4% and 96. 0%,respectively; progestational BMI in GDM group was statistically significantly higher than that in normotension group( P = 0. 027),the educational level in GDM group was statistically significantly higher than that in normotension group( P =0. 002),the incidence rates of preeclampsia and hypertensive disorder complicating pregnancy( HDCP) were low. The pregnant women were divided into normal progestational weight group,overweight group and obesity group; in normal progestational weight group,there was a correlation between body weight gain every week in the first half of pregnancy and GDM risk( P < 0. 05),high body weight gain during pregnancy increased cesarean section rate,body weight gain during pregnancy had no impact on birth weight of infants. Conclusion: Body weight should be increased during pregnancy to maintain the body weight within scientific range.