孕前体质指数及孕期增重对妊娠期糖尿病的影响及其交互作用  

Influence of pre-pregnancy body mass index and gestational weight gain of pregnant women on their gestational diabetes mellitus and their interaction

作　　者：高稚 杨兴华[1] GAO Zhi;YANG Xinghua(School of Public Health,Capital Medical University,Beijing Key Laboratory of Clinical Epidemiology,Beijing,100069;Xuanwu Hospital,Capital Medical University)

机构地区：[1]首都医科大学公共卫生学院临床流行病学北京市重点实验室,北京100069 [2]首都医科大学宣武医院

出　　处：《中国计划生育学杂志》2022年第3期567-572,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨产妇孕前体质指数(BMI)及孕期增重对妊娠期糖尿病(GDM)的影响。方法:采用回顾性队列研究方法,收集首都医科大学宣武医院院2017-2021年4524例分娩产妇数据,通过孕前BMI及孕期增重分组,利用logistic回归分析GDM影响因素,并通过相乘、相加模型分析孕前BMI及孕期增重对于GDM的发生是否存在交互作用。结果:孕前超重、孕前肥胖及孕期增重不足是GDM的危险因素(OR=1.46,95%CI 1.22~1.75;OR=2.17,95%CI 1.68~2.80;OR=1.74,95%CI 1.45~2.09),孕前体重偏低及孕期增重过多是GDM的保护因素(OR=0.67,95%CI 0.51~0.89;OR=0.83,95%CI 0.71~0.98);孕前体重标准-增重不足是GDM的危险因素(OR=1.95,95%CI 1.55~2.45),孕前超重-增重过多是GDM的保护因素(OR=0.54,95%CI 0.38~0.77);相乘模型和相加模型显示,孕前BMI和孕期增重对于GDM无交互作用;结论:孕前BMI和孕期增重均会影响GDM,二者之间无统计学交互作用。Objective:To investigate the influence of body mass index(BMI)before pregnancy and gestational weight gain(GWG)of pregnant women on their gestational diabetes mellitus(GDM).Methods:Retrospective cohort study method was used to collect the data of 4524 delivered women in Xuanwu Hospital from 2017 to 2021.The incidence of GDM of the women with different pre-pregnancy BMI and GWG(in different groups)was compared.Logistic regression was used to compare the occurrence and the influencing factors of GDM of the women in different groups.Multiplication and additive models were used to analyze the interaction between prepregnancy BMI and GWG influenced on GDM.Results:Overweight,obesity before pregnancy,and the insufficient GWG were the risk factors of GDM(OR=1.46,95%CI:1.22-1.75;OR=2.17,95%CI:1.68-2.80;and OR=1.74,95%CI:1.45-2.09),and the low body weight before pregnancy and the excessive GWG were the protective factors of GDM(OR=0.67,95%CI:0.51-0.89;OR=0.83,95%CI:0.71-0.98).Weight standard before pregnancy-insufficient GWG was the risk factor of GDM(OR=1.95,95%CI:1.55-2.45),and overweight before pregnancy-excess GWG was the protective factor of GDM(OR=0.54,95%CI:0.38-0.77).Multiplication model and additive model showed there was no interaction between prepregnancy BMI and GWG influenced on GDM.Conclusion:Both prepregnancy BMI and GWG can affect GDM occurrence,but there was no statistical interaction between prepregnancy BMI and GWG influenced on GDM.

关 键 词：妊娠期糖尿病 孕前体重指数 孕期增重 

分 类 号：R714.256[医药卫生—妇产科学]