BMI变化对妊娠期糖尿病母婴结局的影响  

Effects of body mass index changes during pregnancy on maternal and infant outcomes in pregnant women with gestational diabetes mellitus

作　　者：农小花[1] 黄贞 凌鹏飞 玉春霞 谢艳玲 方丽新 NONG Xiaohua;HUANG Zhen;LING Pengfei(Department of Obstetrics,Baise People’s Hospital,Guangxi,Baise 533000,China;不详)

机构地区：[1]广西壮族自治区百色市人民医院产科,533000 [2]广西国际壮医医院产科

出　　处：《河北医药》2024年第6期930-934,共5页Hebei Medical Journal

基　　金：百色市科学研究与技术开发计划项目(编号:百科20192517)。

摘　　要：目的探讨妊娠期糖尿病(GDM)孕妇孕期不同体重指数(BMI)变化与母婴结局的相关性。方法选取百色市人民医院2019至2021年进行产检、分娩并确诊为GDM的孕妇200例作为研究对象,根据体重(BMI)增长幅度(ΔBMI)变化量将其分成ΔBMI<4 kg/m^(2)组(BMI增长不足组,n=51)、4 kg/m^(2)≤ΔBMI≤6 kg/m^(2)组(BMI增长正常组;n=87)和ΔBMI>6 kg/m^(2)组(BMI增长过多组,n=62)。利用调查问卷发放的方式获取所有受试者的基线资料与实验数据,利用Logistic回归模型分析评估不同BMI变化与母婴结局的相关性。结果BMI增长过多组妊高症、先兆子痫、产后出血各占29.03%、18.03%、41.94%,BMI增长正常组各占19.54%、14.94%、12.64%,BMI增长不足组各占25.49%、7.84%、13.73%。②BMI增长过多组胎儿窘迫、巨大儿各占29.03%、40.32%,BMI增长正常组各占13.79%、14.94%,BMI增长不足组各占9.80%、7.84%。BMI增长过多组产后并发症发生率、新生儿结局不良率较BMI增长正常组、BMI增长不足组更高(P<0.05)。将BMI增长正常作为参照进行Logistic回归分析发现,BMI增长不足会增加妊高症、先兆子痫、产后出血、胎儿窘迫、巨大儿的发生风险(OR=3.376、2.658、1.354、1.713、2.165,P<0.05);BMI增长过多会增加妊高症、先兆子痫、产后出血、胎儿窘迫、巨大儿、低体重儿和GDM的发生风险(OR=2.647、1.659、3.675、4.132、2.876、3.151、3.325)。结论GDM产妇的BMI增长不足、BMI增长过多均会增加母婴结局的不良发生率,故在孕期内控制可监测孕妇的体重增长,不仅有利于母婴的健康,对降低GDM及相关并发症发生率也有积极的影响。Objective To investigate the correlation of body mass index(BMI)changes during pregnancy with maternal and infant outcomes in pregnant women with gestational diabetes mellitus(GDM).Methods Two hundred pregnant women with GDM who underwent pregnant examinations and delivered in Baise People’s Hospital between 2019 and 2021 were selected as study subjects.According to the increase in the Body Mass Index(BMI)during pregnancy(ΔBMI),they were divided into insufficient BMI increase group(ΔBMI<4kg/m^(2),n=51)and normal BMI increase group(4kg/m^(2)≤ΔBMI≤6kg/m^(2),n=87)and excessive BMI increase group(ΔBMI>6kg/m 2,n=62).Baseline information and experimental data of all subjects were obtained using questionnaire survey.The correlation of different BMI changes with maternal and infant outcomes was assessed using Logistic regression model analysis.Results The proportion of pregnancy-induced hypertension,preeclampsia and postpartum hemorrhage in the excessive BMI increase group was 29.03%,18.03%and 41.94%,respectively,which was 19.54%,14.94%,and 12.64%respectively in the normal BMI increase group,and 25.49%,7.84% and 13.73% respectively in the insufficient BMI increase group.The proportion of fetal distress and macrosomia in the excessive BMI increase group was 29.03% and 40.32%,respectively;which was 13.79% and 14.94% respectively in the normal BMI increase group,and 9.80% and 7.84% respectively in the insufficient BMI increase group.The incidence of postpartum complications and adverse neonatal outcomes in the excessive BMI increase group was significantly higher than that of normal BMI increase group and insufficient BMI increase group(P<0.05).With the indices in the normal BMI increase group as references,Logistic regression analysis showed that an insufficient increase in BMI during pregnancy significantly increased the risk of pregnancy-induced hypertension,preeclampsia,postpartum hemorrhage,fetal distress and macrosomia(OR=3.376,2.658,1.354,1.713 and 2.165,respectively;P<0.05).An excessive increase in BMI dur

关 键 词：妊娠期糖尿病 孕妇 孕期不同体重指数变化 母婴结局 相关性 

分 类 号：R714.257[医药卫生—妇产科学]