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目的探讨孕前及不同孕期孕妇体重指数(BMI)与妊娠期糖尿病(GDM)及巨大儿的关系。方法选取2013年1月-2016年3月该院孕妇1 100例为研究对象,分为消瘦组、正常组、超重组和肥胖组,对比孕前、不同孕期4组孕妇GDM发生率及巨大儿发生率;对比非GDM患者孕前、孕期不同体质量巨大儿发生率;对比孕前及不同孕期各层次BMI的GDM孕妇巨大儿发生率。结果 (1)孕前及孕早期超重组和肥胖组孕妇巨大儿及GDM发生率均明显较消瘦组和正常组高;孕中期肥胖组GDM发生率最高,随BMI增加,巨大儿发生率增高;分娩前4 h肥胖组巨大儿发生率最高(P<0.05)。(2)非GDM孕妇中,孕前超重组和肥胖组巨大儿发生率较高;孕早期、中期超重组和肥胖组巨大儿发生率较另两组高;分娩前4h巨大儿发生率随BMI增加而升高(P<0.05)。(3)GDM妇女巨大儿发生率较非GDM孕妇高,孕前及孕期肥胖组巨大儿发生率均为最高(P<0.05)。结论(1)孕前及早期超重、孕中期肥胖增加了GDM发病率,孕前及孕早期超重可增加巨大儿发生率,孕晚期体质量越大则巨大儿发生率越高。(2)非GDM孕妇中,孕前肥胖超重可增加巨大儿发生率,孕早期、中期、晚期BMI越大则巨大儿发生率越高。(3)GDM中,孕前及孕期肥胖可导致巨大儿发生率增加。
Objective To investigate the relationship between body mass index (BMI) and gestational diabetes mellitus (GDM) and macrosomia in pregnant women before and during pregnancy. Methods A total of 1 100 pregnant women in our hospital from January 2013 to March 2016 were selected as study subjects and divided into emaciation group, normal group, overweight group and obesity group. The incidence of GDM and the incidence of macrosomia in pregnant women were compared before and during pregnancy Rate; compared non-GDM patients before pregnancy, pregnancy incidence of different body mass giant children; contrast pre-pregnancy and different levels of pregnant women at different levels of GMI pregnant GUM pregnant women incidence. Results (1) The incidence of GDM and GDM in overweight group and obesity group were significantly higher than those in the control group and the normal group before pregnancy and the first trimester. The incidence of GDM was the highest in the second trimester of pregnancy. The incidence of GDM increased with the increase of BMI. The incidence of macrosomia in the first 4 h obese group was the highest (P <0.05). (2) Among non-GDM pregnant women, the incidence of macrosomia in overweight group and obesity group was higher. The incidence of macrosomia in overweight group and obesity group in early pregnancy was higher than that in other two groups. The incidence of macrosomia in 4h before delivery increased with BMI But increased (P <0.05). (3) The incidence of macrosomia in GDM women was higher than that in non-GDM women, and the incidence of macrosomia was the highest in obesity group before pregnancy and during pregnancy (P <0.05). Conclusions (1) Pre and post-pregnancy overweight and mid-pregnancy obesity increase the incidence of GDM. Overweight before and during the first trimester may increase the incidence of macrosomia. The greater the third trimester pregnancy, the higher the incidence of macrosomia. (2) In non-GDM pregnant women, overweight before pregnancy can increase the incidence of giant children. The higher the BMI, the higher the prevalence of BMI in early, middle and late pregnancy. (3) GDM, pre-pregnancy and pregnancy obesity can lead to an increase in the incidence of macrosomia.