Gestational diabetes: weight gain during pregnancy and its relationship to pregnancy outcomes / 中华医学杂志(英文版)

BACKGROUND@#Weight gain during pregnancy reflects the mother's nutritional status. However, it may be affected by nutritional therapy and exercise interventions used to control blood sugar in gestational diabetes mellitus (GDM). This study aimed to evaluate weight gain during gestation and pregnancy outcomes among women with GDM.@*METHODS@#A retrospective study involving 1523 women with GDM was conducted between July 2013 and July 2016. Demographic data, gestational weight gain (GWG), blood glucose, glycated-hemoglobin level, and maternal and fetal outcomes were extracted from medical records. Relationships between GWG and pregnancy outcomes were investigated using multivariate logistic regression.@*RESULTS@#In total, 451 (29.6%) women showed insufficient GWG and 484 (31.8%) showed excessive GWG. Excessive GWG was independently associated with macrosomia (adjusted odds ratio [aOR] 2.20, 95% confidence interval [CI] 1.50-3.52, P < 0.001), large for gestational age (aOR 2.06, 95% CI 1.44-2.93, P < 0.001), small for gestational age (aOR 0.49, 95% CI 0.25-0.97, P = 0.040), neonatal hypoglycemia (aOR 3.80, 95% CI 1.20-12.00, P = 0.023), preterm birth (aOR 0.45, 95% CI 0.21-0.96, P = 0.040), and cesarean delivery (aOR 1.45, 95% CI 1.13-1.87, P = 0.004). Insufficient GWG increased the incidence of preterm birth (aOR 3.53, 95% CI 1.96-6.37, P < 0.001).@*CONCLUSIONS@#Both excessive and insufficient weight gain require attention in women with GDM. Nutritional therapy and exercise interventions to control blood glucose should also be used to control reasonable weight gain during pregnancy to decrease adverse pregnancy outcomes.

Contribution of depression to instrumental ability of daily living among the elderly with mild cognitive impairment / 预防医学

Objective To examine the independent effect of depression on activities of daily living of patients with mild cognitive impairment (MCI). Methods Data were obtained through the face-to-face interview. Totally 154 elderly patients that were screened from 552 old people by the Montreal Cognitive Assessment (MoCA) were diagnosed as MCI. They were investigated with the Geriatric Depression Scale, and instrumental ability of daily living (IADL) were measured by the Functional Activities Questionnaire. The effect of depression on IADL of patients with MCI was analyzed by logistic regression analysis. Results The prevalence of depressive symptoms among Chinese elders with MCI was 31.82％. The scores of Medical Outcomes Study Social Support Survey, and Functional Activity Questionnaire of depression group and non-depression group were significantly different (P<0.05) . Logistic regression analysis showed that scores of Functional Activity Questionnaire was positively associated with the scores of Memory Inventory for the Chinese (OR=1.36, 95％ CI: 1.15-1.61) and depression (OR=6.19, 95％ CI:2.07-18.55) . Conclusion The prevalence of depression in elderly patients with MCI was high. Depression would significantly reduce the IADL of the old patients with MCI. Medical workers should be aware of the extent and impact of depressive symptoms in MCI and take active measures in evaluating and treating the depressive symptoms.