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目的探讨孕前体质指数(BMI)对妊娠期糖尿病(GDM)孕妇妊娠结局的影响,为改善GDM患者的妊娠结局提供参考依据。方法随机选择2013年1-6月参与天津市孕产期系统管理并确诊为GDM的孕妇1 000例为研究对象,按不同的孕前BMI分组:BMI<18.5 kg/m2为低体重组,18.5 kg/m2≤BMI<24.0 kg/m2为正常体重组,24.0 kg/m2≤BMI<28.0 kg/m2为超重组,BMI≥28.0 kg/m2为肥胖组,以分娩方式、妊娠期高血压、新生儿出生体重为观察指标,对各组数据进行统计分析。结果肥胖组和超重组剖宫产率(分别为81.0%和73.3%)高于正常体重组(62.2%),差异均有统计学意义(P<0.01)。肥胖组和超重组妊娠期高血压发生率(分别为20.0%和8.2%)高于正常体重组(3.9%),差异均有统计学意义(P<0.05,P<0.01)。不同组间巨大儿的发生率差异有统计学意义(P<0.01),肥胖组的巨大儿发生率最高(17.6%)。结论控制妊娠前及妊娠早期肥胖可以改善GDM孕妇的妊娠结局,减少剖宫产率、妊娠期高血压发生率和巨大儿发生率。
Objective To explore the effect of pre-pregnancy body mass index (BMI) on the pregnancy outcome of pregnant women with gestational diabetes mellitus (GDM) and to provide reference for improving the pregnancy outcome in patients with GDM. Methods A total of 1 000 pregnant women who participated in the systematic management of pregnancy during pregnancy from January to June 2013 in Tianjin and were diagnosed as GDM were selected randomly and divided into different pre-pregnancy BMI groups: BMI <18.5 kg / m2, body weight 18.5 kg / m2 /m2≤BMI<24.0 kg / m2 as normal weight group, 24.0 kg / m2≤BMI <28.0 kg / m2 as overweight group, BMI≥28.0 kg / m2 as obese group, with mode of delivery, gestational hypertension, newborn Birth weight as an indicator, the statistical data of each group. Results The rates of cesarean section in obesity group and overweight group were 81.0% and 73.3%, respectively, higher than those in normal weight group (62.2%) (P <0.01). The prevalence of gestational hypertension (20.0% and 8.2%, respectively) in obese and overweight groups was significantly higher than that in normal weight group (3.9%) (P <0.05, P <0.01). The incidence of macrosomia in different groups was significantly different (P <0.01). The incidence of macrosomia in obese group was the highest (17.6%). Conclusions Control of obesity before pregnancy and early pregnancy can improve the pregnancy outcome of pregnant women with GDM and reduce the incidence of cesarean section, the incidence of gestational hypertension and the incidence of macrosomia in pregnant women.