Change in body mass index between pregnancies and the risk of gestational diabetes in a second pregnancy.
Change in body mass index between pregnancies and the risk of gestational diabetes in a second pregnancy.
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DOI：
10.1097/aog.0b013e31821aa358
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发表时间：
2011-06
影响因子：
7.2
通讯作者：
Ferrara A
中科院分区：
文献类型：
--
作者：
Ehrlich SF;Hedderson MM;Feng J;Davenport ER;Gunderson EP;Ferrara A
目的：评估妊娠期体重指数(BMI)变化与再次妊娠患妊娠期糖尿病(GDM)风险之间的关系。在对22,351名妇女的回顾队列分析中，Logistic回归模型提供了对体重指数增加3.0或更多、2.0-2.9和1.0-1.9单位或两次怀孕之间减少1.0-2.0和2.0以上单位的妇女患妊娠期糖尿病风险的调整估计[1个BMI单位相当于研究人群平均身高(5英尺4英寸)的5.9磅]。有稳定BMI(±1.0 BMI单位)的女性构成参考。与保持稳定的妇女相比，孕期BMI增加与第二次妊娠患GDM的风险增加相关[增加1.0-1.9 BMI单位的OR=1.71(95%可信区间1.42-2.07)，2.0-2.9 BMI单位的OR=2.46(95%可信区间2.00-3.02)，3.0或更多BMI单位的OR=3.40(95%可信区间2.81-4.12)]。体重指数单位减少只与首次怀孕时超重/肥胖的女性患妊娠期糖尿病的风险较低相关[OR=0.26(95%可信区间0.14-0.47)，体重指数单位减少超过2.0个单位]。在超重/肥胖妇女中，那些首次怀孕但没有再次发生这种情况的妊娠期糖尿病患者比那些反复发生妊娠期糖尿病的患者增加的BMI单位更少[平均变化0.66(95%可信区间0.25-1.07)对2.00(95%可信区间1.56-2.43)BMI单位]。妊娠期BMI的增加可能会增加妇女怀孕GDM的风险；BMI的减少可能具有保护作用，特别是在超重/肥胖的妇女中。
To estimate the association between inter-pregnancy change in body mass index (BMI) and the risk of gestational diabetes (GDM) in a second pregnancy. In a retrospective cohort analysis of 22,351 women, logistic regression models provided adjusted estimates of the risk of GDM in women gaining 3.0 or more, 2.0-2.9, and 1.0-1.9 BMI units or losing 1.0-2.0 and more than 2.0 units between pregnancies [one BMI unit corresponds to 5.9 pounds for the average height (5 feet 4 inches) of the study population]. Women with stable BMI (± 1.0 BMI unit) comprised the reference. Compared to women who remained stable, inter-pregnancy BMI gains were associated with an increased risk of GDM in the second pregnancy [OR= 1.71 (95% confidence interval 1.42-2.07) for gaining 1.0-1.9 BMI units, OR= 2.46 (95% confidence interval 2.00-3.02) for 2.0-2.9 BMI units, and OR= 3.40 (95% confidence interval 2.81-4.12) for 3.0 or more BMI units]. The loss of BMI units was associated with a lower risk of GDM only among women who were overweight/obese in the first pregnancy [OR= 0.26 (95% confidence interval 0.14-0.47) for the loss of more than 2.0 BMI units]. In overweight/obese women, those with GDM in the first pregnancy that did not develop the condition again gained fewer BMI units than those experiencing recurrent GDM [mean change 0.66 (95% confidence interval 0.25-1.07) vs. 2.00 (95% confidence interval 1.56-2.43) BMI units, respectively]. Inter-pregnancy increases in BMI may increase a woman’s risk of GDM pregnancy; reductions in BMI may be protective, particularly in overweight/obese women.