[1]程 敏,李 青,陈 彬.妊娠体重增加对妊娠期糖尿病的肥胖患者妊娠结局及新生儿结局的影响[J].医学信息,2024,37(10):113-117.[doi:10.3969/j.issn.1006-1959.2024.10.023]
　CHENG Min,LI Qing,CHEN Bin.Effect of Gestational Weight Gain on Pregnancy Outcome and Neonatal Outcome in Obese Patients with Gestational Diabetes Mellitus[J].Journal of Medical Information,2024,37(10):113-117.[doi:10.3969/j.issn.1006-1959.2024.10.023]
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妊娠体重增加对妊娠期糖尿病的肥胖患者妊娠结局及新生儿结局的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年10期
页码:
113-117
栏目:
论著
出版日期:
2024-05-15

文章信息/Info

Title:
Effect of Gestational Weight Gain on Pregnancy Outcome and Neonatal Outcome in Obese Patients with Gestational Diabetes Mellitus
文章编号:
1006-1959（2024）10-0113-05
作者:
程 敏; 李 青; 陈 彬
（安徽医科大学附属安庆医院妇产科，安徽 安庆 246000）
Author(s):
CHENG Min; LI Qing; CHEN Bin
(Department of Obstetrics and Gynecology,Anqing Hospital,Anhui Medical University,Anqing 246000,Anhui,China)
关键词:
妊娠体重增加; 妊娠期糖尿病; 肥胖; 妊娠结局; 新生儿结局
Keywords:
Gestational weight gain; Gestational diabetes mellitus; Obesity; Pregnancy outcome; Neonatal outcome
分类号:
R714.256
DOI:
10.3969/j.issn.1006-1959.2024.10.023
文献标志码:
A
摘要:
目的 比较不同程度妊娠期体重增加（GWG）对孕产妇和新生儿结局的影响。方法 收集2020年12月-2022年12月安徽医科大学附属安庆医院产科分娩的患有妊娠糖尿病的肥胖产妇324例临床资料，根据妊娠期体重增加情况分为GWG不足组（n=110），GWG适当组（n=108），GWG过量组（n=106），比较三组妊娠结局及新生儿结局。结果 与GWG适当组和GWG过量组比较，GWG不足组妊娠期高血压、子痫前期、剖宫产发生率、孕晚期HbA1c均较低，BMI、产后血糖恢复至正常的比例较高，差异有统计学意义（P＜0.05）。GWG不足组新生儿出生体重及巨大儿、LGA的发生率低于GWG适量和GWG过量组（P＜0.05）。Logistic多因素回归分析显示，GWG不足组LGA、子痫前期、需要剖宫产、患糖尿病的风险明显降低。GWG过量组LGA、剖宫产的风险明显增加。结论 妊娠期体重增加过量GDM肥胖妇女不良结局发生率更高，体重增加不足的更有利于得到良好的妊娠结局及新生儿结局。
Abstract:
Objective To compare the effects of different degrees of gestational weight gain (GWG) on maternal and neonatal outcomes.Methods The clinical data of 324 obese pregnant women with gestational diabetes mellitus who gave birth in the obstetrics department of Anqing Hospital, Anhui Medical University from December 2020 to December 2022 were collected. According to the weight gain during pregnancy, they were divided into GWG insufficient group (n=110), GWG appropriate group (n=108) and GWG excessive group (n=106). The pregnancy outcomes and neonatal outcomes of the three groups were compared.Results Compared with the GWG appropriate group and the GWG excessive group, the proportion of gestational hypertension, the proportion of preeclampsia, the incidence of cesarean section and the level of HbA1c in the third trimester were lower in the GWG insufficient group, BMI and the proportion of postpartum blood glucose returning to normal was higher, the difference was statistically significant (P<0.05). The neonatal birth weight and the incidence of macrosomia and LGA in the GWG insufficient group were lower than those in the GWG appropriate and GWG excessive groups (P<0.05). Logistic multivariate regression analysis showed that the risk of LGA, preeclampsia, cesarean section and diabetes in the GWG insufficient group was significantly reduced; the risk of LGA and cesarean section was significantly increased in the GWG excessive group.Conclusion GDM obese women with excessive weight gain during pregnancy have a higher incidence of adverse outcomes, and insufficient weight gain is more conducive to good pregnancy outcomes and neonatal outcomes.

参考文献/References:

[1]American Diabetes Association.2. Classification and Diagnosis of Diabetes:Standards of Medical Care in Diabetes-2021[J].Diabetes Care,2021,44(Suppl 1):S15-S33.[2]Reichetzeder C.Overweight and obesity in pregnancy:their impact on epigenetics[J].Eur J Clin Nutr,2021,75(12):1710-1722.[3]Chen F,Wang P,Wang J,et al.Analysis and Comparison of Early Childhood Nutritional Outcomes Among Offspring of Chinese Women Under the Chinese 2021 and US 2009 Gestational Weight Gain Guidelines[J].JAMA Netw Open,2022,5(9):e2233250.[4]陈俊,刘玉环,徐明娟.妊娠期糖尿病筛查与诊断标准探讨[J].上海医学,2021,44(2):116-120.[5]Champion ML,Harper LM.Gestational Weight Gain: Update on Outcomes and Interventions[J].Curr Diab Rep,2020,20(3):11.[6]唐静静,孙璐.肥胖问题与营养标签制度研究[J].中国食品药品监管,2020,193(2):90-98.[7]Dalfra’ MG,Burlina S,Lapolla A.Weight gain during pregnancy: A narrative review on the recent evidences[J].Diabetes Res Clin Pract,2022,188:109913.[8]吴昊旻,梁旭霞.体脂控制对肥胖孕妇妊娠期糖尿病及母婴结局影响[J].中国计划生育学杂志,2019,27(7):890-893.[9]孟耀涵,曲翌敏,湛永乐,等.妊娠糖尿病的影响因素及围产期结局[J].中华疾病控制杂志,2022,26(9):1011-1016.[10]赵欣.孕前体质量指数正常的妊娠糖尿病孕妇孕期增重与新生儿出生体质量的相关性研究[J].中国药物与临床,2021,21(3):467-469.[11]杨云,张士发.糖尿病母亲新生儿大于胎龄儿的危险因素及近期结局[J].中国儿童保健杂志,2021,29(10):1125-1129.[12]王蓬春,高宁,王怡,等.妊娠期糖尿病患者血糖水平与新生儿结局的相关性及其临床意义[J].中国临床医生杂志,2021,49(1):115-117.[13]Lu L,He L,Hu J,et al.Association between very advanced maternal age women with gestational diabetes mellitus and the risks of adverse infant outcomes: a cohort study from the NVSS 2014-2019[J].BMC Pregnancy Childbirth,2023,23(1):158.[14]徐飞,赵亭亭,沈云.胎儿生长受限的危险因素及分娩孕周对围产儿结局的影响[J].江苏医药,2022,48(2):169-172.[15]孙敬,王晓莹.妊娠期高血压疾病对新生儿早期肾脏功能和脐血胆红素水平的影响[J].中国妇幼保健,2021,36(17):4009-4011.[16]林晶,陈蕾,沈梦尘,等.妊娠期糖尿病孕前体质量指数对糖代谢及妊娠结局的影响[J].实用妇产科杂志,2021,37(6):466-470.[17]Xie X,Liu J,García-Patterson A,et al.Gestational weight gain and pregnancy outcomes in women with type 1 and type 2 diabetes mellitus[J].Acta Diabetol,2023,60(5):621-629.[18]王雪影,周莉.妊娠期糖尿病患者孕前体重指数及孕期体重增加量与妊娠结局及产科并发症关系研究[J].中国实用妇科与产科杂志,2020,36(08):757-761.[19]宋伟,张志,梁胜男,等.肥胖孕妇孕期增重及其与不良妊娠结局的关系[J].中华围产医学杂志,2021,24(5):8-12.[20]Maguolo A,Olivieri F,Zusi C,et al.The risk of metabolic derangements is higher in children and adolescents with overweight or obesity born small for gestational age[J].Nutr Metab Cardiovasc Dis,2021,31(6):1903-1910.

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更新日期/Last Update: 1900-01-01