Relationship Between Excessive Gestational Weight Gain and Neonatal Adiposity in Women With Mild Gestational Diabetes Mellitus.
Relationship Between Excessive Gestational Weight Gain and Neonatal Adiposity in Women With Mild Gestational Diabetes Mellitus.
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DOI：
10.1097/aog.0000000000001773
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发表时间：
2016-12
影响因子：
7.2
通讯作者：
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network
中科院分区：
文献类型：
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作者：
Blackwell SC;Landon MB;Mele L;Reddy UM;Casey BM;Wapner RJ;Varner MW;Rouse DJ;Thorp JM Jr;Sciscione A;Catalano P;Saade G;Caritis SN;Sorokin Y;Grobman WA;Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network
评估轻度妊娠期糖尿病（GDM）孕妇妊娠期体重过度增加、新生儿肥胖和不良产科结局之间的关系。这是一项针对轻度GDM女性患者的多中心随机临床试验的次要分析。根据自我报告的孕前体重，如果妊娠期体重增加大于2009年医学研究所指南，则将其归类为过度。对体重过度增加和体重没有过度增加的孕妇的妊娠结局和新生儿拟人化特征进行比较。进行多元线性和逻辑回归分析以校正混杂因素。我们研究了841名参加主试验并有孕前BMI和分娩信息的妇女（n= 431治疗组，n= 410未治疗）。在调整了治疗和孕前BMI等因素后，体重过度增加仍然与LGA相关（aOR 2.94，95% CI 1.81-4.93），BW > 4000 g（aOR 2.56，95%CI 1.54-4.40）、先兆子痫（aOR 2.96，95%CI 1.35-7.03）和因分娩停止而剖宫产（aOR 2.37，95%CI 1.30-4.44）。此外，体重过度增加与新生儿总脂肪（p < 0.001）和出生体重（p < 0.001）增加独立相关。在接受治疗和未接受治疗的轻度GDM妇女中，妊娠期体重过度增加与出生体重增加和肥胖独立相关。
To evaluate the relationships between excessive gestational weight gain, neonatal adiposity, and adverse obstetric outcomes in women with mild gestational diabetes mellitus (GDM). This is a secondary analysis of a multicenter randomized clinical trial of women with mild GDM. Based on self-reported prepregnancy body weight, gestational weight gain was categorized as excessive if it was greater than 2009 Institute of Medicine guidelines. Maternal outcomes and neonatal anthropomorphic characteristics were compared between women with excessive weight gain and those without excessive weight gain. Multiple linear and logistic regression analyses were performed to adjust for confounding factors. We studied 841 women who participated in the main trial and had prepregnancy BMI and delivery information available (n= 431 treatment group, n= 410 no treatment). After adjustment for factors including treatment and prepregnancy BMI, excessive weight gain remained associated with LGA (aOR 2.94, 95% CI 1.81-4.93), BW > 4000 grams (aOR 2.56, 95% CI 1.54-4.40), preeclampsia (aOR 2.96, 95% CI 1.35-7.03) and cesarean delivery for labor arrest (aOR 2.37, 95% CI 1.30-4.44). In addition, excessive weight gain was independently associated with increased total neonatal fat (p < 0.001) and birth weight (p < 0.001). In women with both treated and untreated mild GDM, excessive gestational weight gain was independently associated with both greater birth weight and adiposity.