Pre-gestational maternal body mass index predicts an increased risk of congenital malformations in infants of mothers with gestational diabetes
Pre-gestational maternal body mass index predicts an increased risk of congenital malformations in infants of mothers with gestational diabetes
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DOI：
10.1111/j.1464-5491.2005.01492.x
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发表时间：
2005-06-01
影响因子：
3.5
通讯作者：
Frías, JL
中科院分区：
文献类型：
--
作者：
Martínez-Frías, ML;Frías, JP;Frías, JL
本研究的目的是确定诊断为妊娠糖尿病（GDM）的妇女的特征，这些特征可以预测婴儿的先天性畸形。方法使用西班牙先天性畸形合作研究（ECEMC）的数据，这是一项基于医院的病例对照研究和监测系统，我们评估了一些母亲变量之间的关系，包括孕前体重指数（BMI）和婴儿的特定先天性畸形。结果与正常糖耐量（NGT）的肥胖母亲相比，患有GDM的肥胖母亲所生婴儿先天性畸形的总风险为2.78 （1.38-5.55,P < 0.001）。在患有GDM的母亲组中，与非肥胖妇女相比，肥胖（BMI = 30 kg/m(2)）与心血管缺陷的风险显著增加相关[OR = 2.82 (1.31-7.04), P < 0.01]。在患有NGT的母亲中，孕前BMI与先天性畸形无关。结论妊娠前肥胖是GDM母亲的婴儿先天性畸形的预测变量。他们的身体质量指数越高，他们的后代患先天性畸形的风险就越高。鉴于已确定的先天性缺陷的胚源性起源，以及肥胖与2型糖尿病之间的关系，这种增加的风险可能是先前未发现的妊娠前糖尿病（PGD）的结果。对计划怀孕的超重和肥胖妇女进行糖尿病评估是很重要的。
Aims The aim of the present study was to identify characteristics in women diagnosed with gestational diabetes mellitus (GDM) that could be predictive of congenital malformations in their infantsMethods Using data from the Spanish Collaborative Study of Congenital Malformations (ECEMC), a hospital-based case-control study and surveillance system, we assessed the relationship between a number of maternal variables, including pre-gestational body mass index (BMI) and specific congenital malformations in their infants.Results The overall risk for a selected group of congenital malformations in an infant of an obese mother with GDM compared with an obese mother with normal glucose tolerance (NGT) was 2.78 (1.38-5.55, P < 0.001). Within the group of mothers with GDM, obesity (BMI >= 30 kg/m(2)) was associated with a significantly increased risk of cardiovascular defects compared with non-obese women [OR = 2.82 (1.31-7.04), P < 0.01]. In mothers with NGT, pre-gestational BMI was not associated with congenital malformations.Conclusion Pre-gestational obesity is a predictive variable for congenital malformations in infants of mothers with GDM. The greater their BMI, the higher the risk for congenital malformations in their offspring. Given the blastogenic origin of the congenital defects identified, and the relationship between obesity and Type 2 diabetes, it is probable that this increased risk is as a result of previously unidentified pre-gestational diabetes mellitus (PGD). It is important that overweight and obese women planning a pregnancy be evaluated for the presence of diabetes.