目的：研究广东地区孕前妇女体重指数(body mass index, BMI)与妊娠期糖尿病(gestational diabetes, GDM)的关系并分析其影响因素。方法：选取2015年1月至2020年10月广东地区产前接受健康体检的妇女488例,将其中18例发生GDM妇女作为GDM组,将470例未发生GDM妇女作为非GDM组,统计分析所有妇女孕前BMI、年龄、身高、产次、腰围等资料。结果：GDM组妇女的BMI高于非GDM组(P＜0.05),腰围高于非GDM组(P＜0.05)。在488例孕妇中,体重在正常范围内74例,轻度增加112例,中度增加136例,重度增加166例。体重在正常范围内的74例孕妇中无GDM病例发生;在体重轻度增加组的112例孕妇中,仅发生1例GDM,约占0.89%;体重增加中度组的136孕妇中,仅发生4例GDM,约占2.94%;体重重度增加组的166例孕妇中,共发生13例GDM,约占7.83%。Logistic回归分析显示,孕妇的孕前BMI(＞26.0 kg/m2)、孕期体重重度增加、腰围(＞74.0 cm)为孕妇发生GDM的危险因素(P＜0.05)。经调整删除孕期体重增加变量后,Logistic回归分析显示孕妇孕前BMI(＞26.0 kg/m2)、腰围(＞74.0 cm)不是GDM发生的危险因素(P＞0.05)。结论：孕前BMI及孕前腰围是广东地区妊娠期妇女患糖尿病的独立危险因素,同时孕期体重增加值与妊娠期患糖尿病存在相关性,对临床调整孕妇孕前BMI和控制孕期体重增加值具有重要的指导意义。
Objective:To study the relationship between pre-pregnancy body mass index(BMI) and gestational diabetes(GDM) and its influencing factors in Guangdong. Methods: A total of 488 women who received prenatal physical examinations from January 2015 to October 2020, in Guangdong were selected. 18 women with GDM were divided into the GDM group, and 470 women without GDM into the non-GDM group, and general data such as pre-pregnancy BMI, age, height, parity, waist circumference of all women were statistically analyzed. Results: Compared with the non-GDM group, the pre-pregnancy BMI (P＜0.05) and waist circumference (P＜0.05) in the GDM group were higher than those in the non-GDM group. There were 74 cases of normal weight gaining, 136 cases of moderate weight gaining, 112 cases of mild weight gaining, and 166 cases of severe weight gaining in the 488 pregnant women. There were no cases of GDM among 74 pregnant women within the normal range of weight gaining. There were only 1 case of GDM occurred in the 112 pregnant women with mild weight gaining, which accounted for about 0.89%. There were 4 cases GDM occurred among 136 pregnant women with moderate weight gaining (2.94%), and there were 13 cases GDM occurred among 166 pregnant women with severe weight gaining (7.83%). Logistic regression analysis showed that the BMI of pregnant women (＞26.0 kg/m2), severe weight gaining during pregnancy, waist circumference (＞74.0 cm) were risk factors for pregnant women to develop GDM. After excluding factor of weight gaining during pregnancy, Logistic regression analysis showed that there was no statistical relationship between BMI and waist circumference (＞74.0 cm) with the occurrence of GDM in pregnant women (P＞0.05). Conclusion: Prenatal BMI and waist circumference are independent risk factors for diabetes in pregnant women in Guangdong, and there is a correlation between gestational weight gaining and gestational diabetes, which has important guiding significance for adjusting prenatal BMI and controlling gestational weight gaining.
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