摘要
目的妊娠前肥胖是妊娠期糖尿病(gestational diabetes mellitus,GDM)发病的高危因素,GDM孕妇易分娩巨大儿。本研究探讨GDM孕妇妊娠前体质量指数(body mass index,BMI)对巨大儿发生情况影响。方法选择2014-01-01-2019-06-30在北京市朝阳区高碑店社区卫生服务中心管理的孕妇为研究对象,孕期诊断为GDM的孕妇566例为病例组,按年龄±3岁匹配选取非GDM的孕妇566名为对照组。分析两组妊娠前BMI与新生儿体质量关系。结果病例组随着妊娠前BMI增加,巨大儿分娩率显著增加,趋势χ~2=6.955,P=0.008。Logistic回归分析结果显示,相对于妊娠前BMI正常的孕妇,妊娠前超重(OR=1.696,95%CI为1.041~2.762,P=0.034)、肥胖(OR=2.188,95%CI为1.137~4.209,P=0.019)的孕妇显著增加巨大儿的发生风险。通过分层分析显示,伴有妊娠前超重(OR=2.003,95%CI为1.065~3.771,P=0.031)、肥胖(OR=2.479,95%CI为1.053~5.836,P=0.038)的GDM患者分娩巨大儿风险更高。结论妊娠前超重、肥胖的孕妇显著增加巨大儿发生风险,GDM孕妇妊娠前超重及肥胖孕妇更易分娩巨大儿,应注意将计划妊娠妇女妊娠前BMI控制在合理范围,同时还应控制GDM孕妇体质量增长范围,以改善母婴结局。
OBJECTIVE Pre-pregnancy obesity is a high-risk factor for the onset of gestational diabetes mellitus(GDM).GDM pregnant women are prone to give birth to large children.This study explores the effect of body mass index(BMI)of pregnant women with GDM on the occurrence of giant children.METHODS From January 1,2014 to June 30,2019,a total of 566 pregnant women diagnosed as GDM during pregnancy were selected as the case group and 566 non GDM pregnant women were selected as the control group according to the age±3-year-old matching.The relationship between BMI before pregnancy and body mass of newborn was analyzed.RESULTS With the increase of BMI before pregnancy in the GDM group,the delivery rate of macrosomia increased significantly(χ~2=6.955,P=0.008).The results of Logistic regression analysis showed that compared with the pregnant women with normal BMI before pregnancy,the pregnant women with overweight before pregnancy(OR=1.696,95%CI:1.041-2.762,P=0.034),obesity(OR=2.188,95%CI:1.137-4.209,P=0.019)significantly increased the risk of macrosomia;Through stratified analysis,GDM patients with overweight before pregnancy(OR=2.003,95%CI:1.065-3.771,P=0.031),obesity(OR=2.479,95%CI:1.053-5.836,P=0.038)significantly increased the risk of macrosomia.CONCLUSIONS Pregnant women with GDM were more likely to give birth to giant babies if they were overweight or obese before pregnancy.Therefore,it was important to control BMI in a reasonable range before pregnancy for women planning pregnancy,especially to strengthen the control of body mass during pregnancy for GDM pregnant women,so as to improve maternal and infant outcomes.
作者
陈洁
王辉
CHEN Jie;WANG Hui(Gaobeidian Community Health Service Center of Chaoyang District in Beijing,Beijing100124,P.R.China)
出处
《社区医学杂志》
2020年第10期713-716,共4页
Journal Of Community Medicine
关键词
妊娠期糖尿病
体质量指数
巨大儿
妊娠结局
gestational diabetes mellitus
body mass index
macrosomia
pregnancy outcome
