妊娠糖尿病孕妇孕期适宜增重探讨  

Investigate Appropriate Weight Gain During Pregnancy of Gestational Diabetes Mellitus

作　　者：周新[1] 张勍烨[1] 林彤[1] 赵霞[1] 金珍珍[2] ZHOU Xin;ZHANG Qing-ye;LIN Tong;ZHAO Xia;JIN Zhen-zhen(Nutritional Department,Beijing Jishuitan Hospital,Beijing 100035,China;Ultrasonography Department,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院营养科,北京100035 [2]北京积水潭医院超声科,北京100035

出　　处：《中国食物与营养》2021年第6期60-64,共5页Food and Nutrition in China

基　　金：北京积水潭医院青年基金“孕期益生菌的应用对妊娠糖尿病预防作用探索”(项目编号:QN-201918)。

摘　　要：目的:分析妊娠糖尿病(GDM)孕妇孕期各阶段体重增重情况,为GDM的预防及控制提供科学数据。方法:选取2018年10月—2019年10月在我院定期产检并分娩的孕妇700例。通过病历查询获取孕妇一般情况、妊娠期各时期体重以及妊娠结局和新生儿体重,与非GDM孕妇及IOM标准比较,分析不同孕前BMI的GDM孕妇妊娠期各阶段增重情况。结果:与非GDM孕妇相比,GDM孕妇其生产年龄、孕前BMI、有无糖尿病家族史、孕期各阶段增重及总增重差异均有统计学意义(P <0.05)。孕妇早孕期增重过快会增加GDM的发病风险(OR=1.187,95%CI 1.090-1.293)。不同孕前BMI的GDM孕妇其孕24周后增重及总增重均较非GDM组更少(P <0.05),与IOM标准比较,两组增重不足、增重适宜及增重过度人数差异有统计学意义(P <0.05)。仅孕前体重正常组的GDM孕妇早孕期及孕12~24周增重与非GDM组差异有统计学意义(P <0.05),与IOM标准比较后的各组人数差异有统计学意义(P <0.05)。按新生儿体重分组,排除早产的47例孕妇,发现各组间母亲孕期各阶段体重增长差异均无统计学意义(P>0.05)。结论:加强早孕期体重管理有助于降低GDM的发病风险。对于已确诊GDM的孕妇其24周后体重增长普遍低于非GDM组及IOM标准,其适宜增重范围有待进一步研究。[Objective] To study appropriate weight gain during pregnancy of GDM to provide scientific basis for prevention and management of GDM.[Method] A total of 700 pregnancy women from October 2018 to October 2019 were enrolled,and the weight during pregnancy,pregnancy outcome and neonatal weight of GDM were collected to analyze the weight gain during pregnancy compared with non-GDM women and standard gain value.[Result] There were differences between GDM and non-GDM women in age,pre-pregnancy BMI,family history of diabetes and weight gain during the each stage of pregnancy.Excessive gestation weight gain in the first trimester was associated with increased risk of GDM (OR=1.187,95% CI 1.090~1.293).It was less of weight gain after 24 weeks gestation and total gain in GDM women compared with non-GDM,and it was different of the number of appropriate growth women,overgrowth women and insufficient growth women compared with standard gain value.There were differences between GDM and non-GDM women in gestation weight gain of first trimester and 12 ~24 weeks only in pregnancy women whose pre-pregnancy BMI normal,and it was different of the number of women in appropriate,excessive and insufficient growth compared with standard gain value.There were not differences among weight gain during the each stage of pregnancy in different neonatal weight group excluded pregnancy with preterm birth.[Conclusion] Strengthening the weight management during the early pregnancy is helpful to reduce the incidence of GDM.The weight gain after 24 weeks gestation of GDM women was less than non-GDM women and standard gain value.The suitable range of weight gain needs to be further studied.

关 键 词：妊娠期糖尿病 孕期增重 孕前体质指数 

分 类 号：R714.256[医药卫生—妇产科学]