妊娠期糖尿病孕妇孕前正常体重指数与妊娠结局的相关性
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R714.256

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国家自然科学基金面上项目(82371697,81971410);国家重点研发计划(2022YFC2703503)


Association between normal range prepregnancy BMI in patients with gestational diabetes mellitus and pregnancy outcomes
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    摘要:

    目的:探讨正常孕前体重指数(body mass index,BMI)的妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇不同 BMI范围对妊娠结局的影响。方法:回顾性收集南京市妇幼保健院2022年5月—2023年5月孕前正常BMI的GDM孕妇2 319例,按照孕前 BMI 分为 A 组(18.5 kg/m2 ≤BMI<20.0 kg/m2 ,581 例)、B 组(20.0 kg/m2 ≤BMI<22.0 kg/m2 ,922 例)与 C 组(22.0 kg/m2 ≤ BMI<24.0 kg/m2 ,816例)。拟合Logistic回归模型,对不同孕前BMI与妊娠结局的相关性进行分析评价。结果:3组GDM患者发生GDM A2级、子痫前期、巨大儿和新生儿高胆红素血症的风险随孕前BMI的升高而增加;发生胎盘早剥、新生儿低血糖症的风险随孕前BMI的升高而降低。在正常BMI人群中,GDM女性孕前较高或较低的BMI水平是发生GDM A2级、子痫前期、巨大儿、新生儿高胆红素血症、胎盘早剥和新生儿低血糖症的独立危险因素。结论:早期体重管理可能是预防GDM孕妇不良妊娠结局发生的不容忽视的关键措施之一。

    Abstract:

    Objective:To explore the impact of different body mass index(BMI)ranges of gestational diabetes mellitus(GDM) pregnant women with normal pre-pregnancy BMI on pregnancy outcomes. Methods:A retrospective collection of 2,319 cases of GDM pregnant women with normal pre -pregnancy BMI from May 2022 to May 2023 at Nanjing Maternal and Child Health Hospital. They were divided into Group A(18.5 kg/m2 ≤BMI<20.0 kg/m2 ,581 cases),Group B(20.0 kg/m2 ≤BMI<22.0 kg/m2 ,922 cases),and Group C (22.0 kg/m2 ≤BMI<24.0 kg/m2 ,816 cases)according to pre-pregnancy BMI. Logistic regression was used to analyze and evaluate the association between different BMI levels and pregnancy outcomes. Results:The risk of GDM A2 level,preeclampsia,macrosomia,and neonatal hyperbilirubinemia in the three groups of GDM patients increased with the increase of pre-pregnancy BMI;the risk of placental abruption and neonatal hypoglycemia decreased with the increase of pre-pregnancy BMI. In the normal BMI population, higher or lower pre-pregnancy BMI levels in GDM women are independent risk factors for GDM A2 level,preeclampsia,macrosomia, neonatal hyperbilirubinemia,placental abruption,and neonatal hypoglycemia. Conclusion:Early weight management may be one of the key measures to prevent adverse pregnancy outcomes in GDM pregnant women.

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朱家敏,王姗姗,诸清逸,林宇,石中华.妊娠期糖尿病孕妇孕前正常体重指数与妊娠结局的相关性[J].南京医科大学学报(自然科学版),2024,(4):505-510

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  • 收稿日期:2023-11-02
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  • 在线发布日期: 2024-04-11
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