孕期2型糖尿病妇女的最佳妊娠体重增加:中国的一项基于人口的队列研究
Yiwei Xue1, Zifeng Cui1, Xinyu Shu1
1Department of Obstetrics and Gynecology and Reproductive Medicine, Peking University First Hospital, Beijing, China.
Diabetology & metabolic syndrome
|August 19, 2025
概括
孕期体重增加 (GWG) 准则需要针对2型糖尿病 (T2DM) 怀孕进行调整. 量身定制的,BMI特定的GWG目标对于优化T2DM超重和肥胖妇女的结果至关重要.
科学领域:
- 产科和妇科 产科和妇科
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 全球妊娠前2型糖尿病 (T2DM) 的增长率与超重和肥胖症的增加相吻合.
- 在T2DM怀孕中,有效的妊娠体重增加 (GWG) 管理对于母亲和新生儿健康至关重要.
- 目前的GWG指南缺乏针对T2DM高风险怀孕的具体性.
研究的目的:
- 评估GWG偏差对T2DM妇女不良妊娠结果的影响.
- 为了确定T2DM怀孕的最佳体质指数 (BMI) 特定的GWG目标.
- 为各种BMI类别制定量身定制的GWG建议提供信息.
主要方法:
- 对2078例T2DM怀孕的全国性多中心队列的分析.
- 根据最新的中国指南对GWG进行分类.
- 多变量回归,四分位数区间 (IQR) 分析和受限制的立方线来评估GWG的影响并确定目标.
主要成果:
- 不够的GWG降低了剖腹产,LGA和巨的风险,但增加了早产和先天异常的风险.
- 过度的GWG增加了孕前,LGA,巨和新生儿低血糖症的风险.
- 确定BMI特定的GWG范围:7.0-12.5公斤 (正常),5.0-11.0公斤 (超重) 和4.0-11.2公斤 (肥胖),在超重/肥胖女性中,GWG的好处低于指导值.
结论:
- 现有的GWG指导方针可能对T2DM怀孕不够理想,特别是在超重和肥胖的人群中.
- 针对BMI的特定GWG建议是必要的,以改善母亲和新生儿的结果.
- 进一步的研究应侧重于改进T2DM怀孕中不同母体BMI的GWG目标.
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