摘要
目的:观察不同孕前体质量指数(BMI)对妊娠期糖尿病(GDM)孕妇糖代谢和妊娠结局的影响。方法:对709例GDM孕妇进行回顾性分析,根据孕前BMI指数将GDM孕妇分为4组,低BMI组(BMI<18.5 kg/㎡)57例、正常BMI组(18.5 kg/㎡≤BMI<24.0 kg/㎡)460例、超重组(24.0 kg/㎡≤BMI<28.0 kg/㎡)142例和肥胖组(BMI≥28.0 kg/㎡)50例,比较4组孕期糖代谢相关指标及妊娠不良结局。结果:(1)超重组和肥胖组的糖化血红蛋白(HbA1c)、OGTT空腹血糖(OGTT-FPG)、餐后1小时血糖(OGTT-1h)、空腹胰岛素(FIN)、稳态模式胰岛素抵抗指数(HOMA-IR)、胰岛β细胞分泌指数(HOMA-β)水平明显高于低BMI组和正常BMI组(P<0.05)。(2)超重组和肥胖组的孕期增重明显低于低BMI组和正常BMI组(P<0.05),但其孕期过度增重比例明显高于低BMI组和正常BMI组(P<0.05)。而超重组的新生儿出生体质量显著高于低BMI组和正常BMI组(P<0.05)。(3)4组GDM孕妇剖宫产、产后出血(PPH)、妊娠期高血压疾病(HDP)、大于胎龄儿(LGA)发生的比例差异均有统计学意义(P<0.05),且与孕前BMI呈正相关关系(r>0,P<0.05)。结论:孕前BMI的异常增加了GDM孕妇孕期糖代谢紊乱和特定不良产科预后的发生。
Objective:To observe the effects of different pre-pregnancy body mass index(BMI)on glucose metabolism and pregnancy outcome in pregnant women with gestational diabetes mellitus(GDM).Methods:709pregnant women with GDM were retrospectively analyzed.According to the pre pregnancy BMI index,they were divided into 4 groups:low body mass group(BMI<18.5 kg/㎡,Un-GDM group,n=57),normal body mass group(18.5 kg/㎡≤BMI<24.0 kg/㎡,,No-GDM group,n=460),overweight group(24.0 kg/㎡≤BMI<28.0 kg/㎡,Ov-GDM group,n=142)and obesity group(BMI≥28.0 kg/㎡,Ob-GDM group,n=50).The indexes related to glucose metabolism during pregnancy and adverse pregnancy outcomes were compared among the four groups.Results:(1)The levels of HbA1c,OGTT-FPG,OGTT-1h,FIN,HOMA-IR and HOMA-βin Ov-GDMgroup and Ob-GDM group were significantly higher than those in Un-GDM group and No-GDM group(P<0.05).(2)The weight gain during pregnancy in Ov-GDM group and Ob-GDM group was significantly lower than that in Un-GDM group and No-GDM group(P<0.05),but the proportion of excessive weight gain during pregnancy was significantly higher than that in Un-GDM group and No-GDM group(P<0.05).However,the average birth weight of newborns in Ov-GDM group was significantly higher than that in Un-GDM group and No-GDM group(P<0.05).(3)There were statistical differences in the incidence of cesarean section,PPH,HDP and LGA in 4 groups of GDM pregnant women(P<0.05),and there was a positive correlation between cesarean section,PPH,LGAand pre-pregnancy BMI(r>0,P<0.05).Conclusions:Abnormal pre-pregnancy BMI increases the incidence of glucose metabolism disorder and specific adverse obstetrical prognosis in women with GDM.
作者
林晶
陈蕾
沈梦尘
靳化
钟建容
LIN Jing;CHEN Lei;SHEN Mengchen(Department of Obstetrics and Gynecology,Fujian Provincial Hospital,Fujian Fuzhou 350001,China;Department of Obstetrics and Gynecology,The Sixth Medical Center of PLA General Hospital,Beijing 100048,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2021年第6期466-470,共5页
Journal of Practical Obstetrics and Gynecology
基金
首都卫生发展科研专项(编号:首发2020-1-5112)。
关键词
妊娠期糖尿病
体质量指数
糖代谢
妊娠结局
Gestational diabetes mellitus
Body mass index
Glucose metabolism
Pregnancy outcomes
