Association Of Body Mass Index And Gestational Weight Gain During Pregnancy On Adverse Outcome Of Infants With Gestational Diabetes Mellitus

Objective:Obesity is an independent risk factor for gestational diabetes and is common in women of child-bearing age.Many studies have confirmed that gestational diabetes and obesity can lead to more adverse outcomes than gestational age,premature birth,shoulder dystocia and other adverse outcomes.There have been many studies on pre-pregnancy body mass index,weight gain during pregnancy and adverse pregnancy outcomes,especially on adverse offspring outcomes,but few studies have been conducted on women with GDM.And in 2009,the Institute of Medicine(IOM)recommended an internationally accepted range of weight gain for pregnant women.Based on the above research background,this study based on clinical data collection,sorting,induction,tried to analyze pregnancy body mass index and weight gain during pregnancy on that the influence of adverse outcome of gestational diabetes to guide the weight management of gestational diabetes women.Methods:In January 2017 to August 2017 in jining medical college affiliated hospital routine antenatal examination women during pregnancy and childbirth as the research object,all the women during pregnancy in the 24 to 28 weeks of pregnancy for 75 g oral glucose tolerance test.Refer to the American diabetes association study,published in 2011 GDM diagnosis standard: fasting plasma glucose or greater tendency for 5.1 /L,1 hour after taking sugar glucose or greater tendency for 10.0 / L,2 hours blood glucose or greater tendency for 8.5 / L,if the term 1 point higher than normal blood glucose values can be diagnosed with GDM.The glucose tolerance screening test above diagnosed as GDM in 1425 cases.Collect age,production time,glycosylated hemoglobin(glycated hemoglobin A1 c,HbA1c),pregnancy weight,height,weight,premature birth,SGA before delivery,the LGA,neonatal hypoglycemia,neonatal clinical data,such as the high blood bilirubin.A total of 1123 cases were included in gdm23 cases,including diabetes mellitus or abnormal glucose tolerance,twins,taking drugs affecting glycolipid metabolism,stillbirth,stillbirth and chronic diseases,etc.,before pregnancy.According to the consensus of Chinese medical nutrition experts onoverweight/obesity in 2016,pre-pregnancy body mass index is classified as follows:BMI<18.5 is too low;BMI<24.0 is normal;24.0 or less BMI < 28.0 overweight;A BMI greater than or equal to 28.0 is considered obese.Weight gain during pregnancy is the difference between weight gain before birth and weight loss before pregnancy.According to the 2009 national academy of medical sciences(IOM)recommends corresponding GWG goal is: low body quality of pregnant women gain weight range 12.5 ~ 18 kg,normal body quality of pregnant women from 16 to 11.5kg,overweight pregnant 7 ~ 11.5 kg,obese pregnant women 5 ~ 9 kg;According to this,it was divided into three groups: insufficient weight gain,appropriate weight gain and excessive weight gain.Respectively for BMI,weight gain during pregnancy and glycosylated hemoglobin before childbirth and pregnancy increased emphasis on BMI between groups of hierarchical analysis to study the aderse outcome of gestational diabetes children to analyze the influence of GDM women weight management.Result:1.The common adverse outcomes of GDM offspring were premature birth,LGA and SGA.2.Compared with GDM pregnant women with normal BMI before pregnancy,overweight and obese GDM pregnant women are more likely to give birth to LGA,with risk factors of 2.07 and 4.66,respectively.However,patients with GDM who were obese before pregnancy had a lower risk of SGA delivery,with a risk coefficient of 0.09.3.Compared with GDM pregnant women who gain weight appropriately during pregnancy,those who gain too much weight during pregnancy have a higher risk of giving birth to LGA,and the risk factor after adjusting for confounding factors is 2.48.But women with GDM who gain too much weight before pregnancy have a lower risk of premature birth.4.Stratified analysis was carried out in each group that gained weight during pregnancy,and it was found that the increased glycosylated hemoglobin in GDM pregnant women who gained too much weight during pregnancy may increase therisk of LGA.5.Stratified analysis of BMI in each group before pregnancy revealed that compared with normal weight,overweight and obese GDM pregnant women,low-weight GDM pregnant women before pregnancy had a higher risk of LGA if they gained too much weight during pregnancy.Conclusion:GDM pregnant women who are overweight,obese and overweight before pregnancy and who gain too much weight during pregnancy increase the risk of LGA.The risk of LGA in low weight GDM pregnant women before pregnancy is higher than that in normal weight,overweight and obese GDM pregnant women before pregnancy if they gain too much weight during pregnancy.However,pregnant women with GDM who gain too much weight during pregnancy,such as increased hemoglobin a1 c,may increase the risk of LGA.