基于WS/T801-2022的孕期体重增加量与孕晚期GDM发生的关系  

Relationship between weight gain during pregnancy and the occurrence of GDM in late-term pregnancy based on WS/T801-2022

作　　者：张耀炀 范婷 王玮琪 刘家琦 王丽霞[2] ZHANG Yaoyang;FAN Ting;WANG Weiqi;LIU Jiaqi;WANG Lixia(Graduate School,Dalian Medical University,Dalian 116044,China;Department of Obstetric,the Second Hospital of Dalian Medical University,Dalian 116027,China)

机构地区：[1]大连医科大学研究生院,辽宁大连116044 [2]大连医科大学附属第二医院产科,辽宁大连116027

出　　处：《大连医科大学学报》2024年第1期34-41,共8页Journal of Dalian Medical University

摘　　要：目的探讨孕期体重增加量对孕晚期发生妊娠期糖尿病(GDM)的影响,为临床防治孕晚期GDM提供依据。方法选取2022年1月1日至2022年12月31日大连医科大学附属第二医院收治的457例孕妇为研究对象,共入组孕晚期GDM孕妇105例(GDM组),糖代谢正常孕妇352例(非GDM组),参考《妊娠期妇女体重增长推荐值标准》(WS/T801-2022),根据孕妇孕前体质指数(BMI)将GDM组及非GDM组孕妇分为4组,即偏瘦组、正常组、超重组、肥胖组,再根据孕期体重增加量,每组又分为增重过少组、增重适宜组及增重过多组3个亚组。在偏瘦组、正常组、超重组、肥胖组内,分别比较非GDM组与GDM组年龄、身高、孕前BMI、孕周、孕前体重、孕期体重增加量、孕次及各亚组体重增加量的差异,比较各孕期体重增加量亚组孕妇年龄、身高、孕前BMI、孕周、孕前体重、GDM发生例数及孕次的差异,再行Logistic多因素回归分析孕晚期发生GDM的影响因素。结果偏瘦组内,非GDM组孕前体重、孕期体重增加量及增重适宜组增加量高于GDM组,增重过少组增加量低于GDM组,差异具有统计学意义(P<0.05),各亚组GDM发生率的差异具有统计学意义(χ^(2)=6.801,P=0.048),孕期增重过少(OR=7.140,95%CI 1.147~44.466,P=0.035)是孕晚期发生GDM的危险因素。正常组内,非GDM组孕期体重增加量及增重过少组增加量低于GDM组,差异具有统计学意义(P<0.05),各亚组GDM发生率的差异具有统计学意义(χ^(2)=7.543,P=0.023),孕期增重过多(OR=2.456,95%CI 1.147~5.256,P=0.021)是孕晚期发生GDM的危险因素。超重组内,非GDM组孕次少于GDM组,孕前体重增加量高于GDM组,差异具有统计学意义(P<0.05),各亚组GDM发生率的差异具有统计学意义(χ^(2)=6.083,P=0.048),孕期增重过多(OR=3.378,95%CI 1.215~11.510,P=0.021)是孕晚期发生GDM的危险因素。结论相关医疗机构在对所辖区域孕妇进行产检及宣教时,应注重进行孕期体重增加Objective To investigate the impact of weight gain during pregnancy on the occurence of gestitional diabetes mellitus(GDM)in the third trimester of pregnancy,providing a basis for the clinical prevention and treatment of GDM in late pregnancy.Methods The study included 457 pregnant women,who were admitted to the Second Hospital of Dalian Medical University from January 1,2022 to December 31,2022.Among them,105 pregnant women had GDM in the third trimester(GDM group)and 352 pregnant women had normal glucose metabolism(non-GDM group).According to the"recommended value of weight gain for pregnant women"(WS/T801-2022),the pregnant women in both GDM and non-GDM groups were categorized into four groups based on their pre-pregnancy body mass index(BMI):lean group,normal group,overweight group and obese group.Each group was further divided into three subgroups based on the amount of weight gain during pregnancy(GWG):inadequate GWG group,adequate GWG group and excessive GWG group.The differences in age,height,prepregnancy BMI,gestational weeks,pre-pregnancy weight,weight gain during pregnancy,parity and weight gain within each BMI category(lean,normal,overweight and obese)were compared between the non-GDM group and the GDM group.The differences in maternal age,height,pre-pregnancy BMI,gestational weeks,pre-pregnancy weight,incidence of GDM and parity were compared among the GWG subgroups.Multivariate logistic regression analysis was performed to identify the effect of GWG on GDM in late pregnancy.Results Within the lean group,the pre-pregnancy weight gain,gestational weight gain,and adequate weight gain group in the non-GDM group were significantly higher than those in the GDM group,while the inadequate weight gain group was significantly lower than that in the GDM group(P<0.05).The incidence of GDM was also statistically significant in the GWG subgroups(χ2=6.801,P=0.048),and under weight gain during pregnancy(OR=7.140,95%CI 1.147-44.466,P=0.035)was a risk factor for GDM in the third trimester of pregnancy.In the normal

关 键 词：妊娠期糖尿病 孕晚期 OGTT 体质指数 

分 类 号：R714.256[医药卫生—妇产科学]