摘要
目的探讨孕前BMI和孕期体重增长对妊娠期糖尿病(GDM)患者妊娠结局的影响。方法回顾性收集2020年1月-2021年12月在北京大学第一医院宁夏妇女儿童医院住院分娩的752例GDM患者的病历资料。根据中国营养学会制定的妊娠期体重监测与评价标准,将GDM患者孕前BMI分为低体重组、正常体重组及超重肥胖组,将孕期体重增长分为适宜、不足及过度组。分析比较孕前BMI及孕期体重增长对妊娠结局的影响。结果孕前低体重47例(6.25%)、正常体重399例(53.06%)、超重肥胖306例(40.69%);孕期体重增长不足47例(6.25%)、增长适宜295例(39.23%)、增长过度410例(54.52%)。(1)校正混杂因素后,与孕前正常体重组相比,孕前超重肥胖组发生妊娠期高血压(OR=2.715,95%CI为1.438~5.126,P=0.002)、子痫前期(OR=4.727,95%CI为1.854~12.055,P=0.001)、剖宫产术分娩(OR=1.469,95%CI为11.039~2.077,P=0.030)、妊娠合并贫血(OR=1.606,95%CI为1.132~2.278,P<0.001)、妊娠合并肥胖(OR=13.182,95%CI为7.953~21.850,P<0.001)的风险显著增加。(2)校正混杂因素后,与孕期体重增长适宜组相比,孕期体重增长过度组发生妊娠合并肥胖(OR=3.155,95%CI为1.841~5.271,P<0.001)、巨大儿(OR=2.114,95%CI为1.267~3.527,P=0.004)的风险显著增加。结论孕前超重肥胖及孕期体重增长过度的GDM患者易发生不良妊娠结局。因此,针对孕前超重肥胖和孕期体重增长过度的孕妇,应制订个体化的医学营养治疗,改善饮食习惯和生活方式,从而促进母婴健康。
Objective To explore the effects of pre-pregnancy body mass index(BMI)and gestational weight gain on pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods The medical records of 752 patients with GDM who delivered in Peking University First Hospital Ningxia Women's and Children's Hospital from January 2020 to December 2021 were retrospectively collected.According to the gestational weight monitoring and evaluation standard established by Chinese Nutrition Society,the pre-gestational BMI of GDM patients was divided into low weight group,normal weight group,and overweight and obesity group,and the gestational weight gain was divided into appropriate,inadequate,and excessive groups.The effects of pre-pregnancy BMI and gestational weight gain on pregnancy outcomes were analyzed and compared among these groups.Results Before pregnancy,47 cases(6.25%)were low weight,399 cases(53.06%)were normal weight,306 cases(40.69%)were overweight and obese;There were 47 cases(6.25%)with insufficient weight gain,295 cases(39.23%)with appropriate weight gain,and 410 cases(54.52%)with excessive weight gain.(1)After adjusting for confounding factors,compared with the normal weight group before pregnancy,the overweight and obese group before pregnancy had gestational hypertension(OR=2.715,95%CI was 1.438-5.126,P=0.002)and preeclampsia(OR=4.727,95%CI was 1.854-12.055,P=0.001),cesarean section delivery(OR=1.469,95%CI was 11.039-2.077,P=0.030),pregnancy with anemia(OR=1.606,95%CI was 1.132-2.278,P<0.001),pregnancy with obesity(OR=13.182,95%CI was 7.953-21.850,P<0.001).(2)After adjusting for confounding factors,compared with the appropriate gestational weight gain group,the excessive gestational weight gain group had gestational obesity(OR=3.155,95%CI was 1.841-5.271,P<0.001)and macrosomia(OR=2.114,95%CI was 1.267-3.527,P=0.004)had a significantly increased risk.Conclusion GDM patients with overweight and obesity before pregnancy and excessive weight gain during pregnancy are prone to adverse pregnancy outcomes.Therefore,for pregnant women with overweight and obesity before pregnancy and excessive weight gain during pregnancy,individualized medical nutrition treatment should be formulated to improve dietary habits and lifestyle,and promote maternal and infant health.
作者
张燕
张广意
马嫔
徐丽莉
米光丽
ZHANG Yan;ZHANG Guangyi;MA Pin;XU Lili;MI Guangli(Ningxia Medical University General Hospital,Yinchuan 750000,Ningxia,China;Peking University First Hospital Ningxia Women's and Children's Hospital,Yinchuan 750000,Ningxia,China;People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750000,Ningxia,China)
出处
《护士进修杂志》
2023年第21期1960-1965,1970,共7页
Journal of Nurses Training
基金
宁夏回族自治区科技惠民计划专项(编号:2022CMG03014)
宁夏回族自治区卫生健康系统科研课题(编号:2021-NW-043)
宁夏高校一流学科建设二期项目重点培育学科护理学科研课题(编号:NYHLZD05)。
关键词
妊娠期糖尿病
体质指数
妊娠期体重增长
超重肥胖
妊娠结局
gestational diabetes mellitus
body mass index
weight gain during pregnancy
overweight and obesity
pregnancy outcomes
