妊娠期糖尿病孕妇孕前正常体质指数与妊娠结局的相关性
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1.南京医科大学生殖医学与子代健康全国重点实验室;2.南京医科大学常州医学中心,常州市妇幼保健院;3.南京市妇幼保健院

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


Association between normal range pre-pregnancy BMI in patients with gestational diabetes mellitus and pregnancy outcomes
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1.State Key Laboratory of Reproductive Medicine and Offspring Health of Nanjing Medical University;2.Changzhou Maternal and Child Health Care Hospital, Changzhou Medical Center, Nanjing Medical University

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The National Natural Science Foundation of China General Program (82371697, 81971410); National Key R&D Program of China (2022YFC2703503)

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    摘要:

    目的:探讨正常孕前体质指数(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2319例,按照孕前BMI分为A组(18.5≤BMI<20 kg/m2,581例)、B组(20≤BMI<22 kg/m2,922例)与C组(22≤BMI<24 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。结论: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。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≤BMI<20 kg/m2, 581 cases), Group B (20≤BMI<22 kg/m2, 922 cases), and Group C (22≤BMI<24 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. Conclusion: 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. Early weight management may be one of the key measures to prevent adverse pregnancy outcomes in GDM pregnant women.

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  • 收稿日期:2023-11-02
  • 最后修改日期:2024-02-21
  • 录用日期:2024-03-28
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