UNASSIGNED: This retrospective cohort study included 691 Chinese women with type 2 diabetes mellitus from 2012 to 2020. The study utilized a statistical-based approach to determine the optimal range of gestational weight gain. Additionally, multivariate logistic regression analysis was conducted to assess the impact of gestational weight gain on pregnancy outcomes.
UNASSIGNED: (1) In the obese subgroup, gestational weight gain below the recommendations was associated with decreased risks of large for gestational age (adjusted odds ratio [aOR] 0.19; 95% confidence interval [CI] 0.06-0.60) and macrosomia (aOR 0.18; 95% CI 0.05-0.69). In the normal weight subgroup, gestational weight gain below the recommendations of the Institute of Medicine was associated with decreased risks of preeclampsia (aOR 0.18; 95% CI 0.04-0.82) and neonatal hypoglycemia (aOR 0.38; 95% CI 0.15-0.97). (2) In the normal weight subgroup, gestational weight gain above the recommendations of the Institute of Medicine was associated with an increased risk of large for gestational age (aOR 4.56; 95% CI 1.54-13.46). In the obese subgroup, gestational weight gain above the recommendations was associated with an increased risk of preeclampsia (aOR 2.74; 95% CI 1.02, 7.38). (3) The optimal ranges of gestational weight gain, based on our study, were 9-16 kg for underweight women, 9.5-14 kg for normal weight women, 6.5-12 kg for overweight women, and 3-10 kg for obese women. (4) Using the optimal range of gestational weight gain identified in our study seemed to provide better prediction of adverse pregnancy outcomes.
UNASSIGNED: For Chinese women with type 2 diabetes, inappropriate gestational weight gain is associated with adverse pregnancy outcomes, and the optimal range of gestational weight gain may differ from the Institute of Medicine recommendations.
■这项回顾性队列研究纳入了2012年至2020年的691名中国2型糖尿病女性。该研究利用基于统计的方法来确定妊娠体重增加的最佳范围。此外,采用多因素logistic回归分析评估妊娠期体重增加对妊娠结局的影响。
■(1)在肥胖亚组中,低于建议的孕周体重增加与胎龄较大(校正比值比[aOR]0.19;95%置信区间[CI]0.06~0.60)和巨大儿(aOR0.18;95%CI0.05~0.69)的风险降低相关.在正常体重亚组中,低于医学研究所建议的妊娠期体重增加与子痫前期风险降低(aOR0.18;95%CI0.04-0.82)和新生儿低血糖风险降低(aOR0.38;95%CI0.15-0.97)相关.(2)在正常体重亚组中,高于医学研究所建议的妊娠期体重增加与孕龄较大风险增加相关(aOR4.56;95%CI1.54~13.46).在肥胖亚组中,超过建议的妊娠期体重增加与先兆子痫风险增加相关(aOR2.74;95%CI1.02,7.38).(3)孕期增重的最佳范围,根据我们的研究,体重不足的女性为9-16公斤,体重正常的女性9.5-14公斤,超重女性6.5-12公斤,肥胖女性3-10公斤。(4)使用我们研究中确定的最佳妊娠体重增加范围似乎可以更好地预测不良妊娠结局。
■对于患有2型糖尿病的中国女性,妊娠期不适当的体重增加与不良妊娠结局有关,妊娠体重增加的最佳范围可能与医学研究所的建议不同。