The value of pre-pregnancy BMI, gestational maximum fasting blood glucose and weight gain during pregnancy to evaluate fetal macrosomia after 28 weeks of gestational diabetes mellitus / 中国医师杂志

ABSTRACT

Objective:To analyze the relationship between pre-pregnancy body mass index (BMI), gestational random fasting glucose maximum, weight gain during pregnancy, and the occurrence of macrosomia in pregnant women diagnosed with gestational diabetes after 28 weeks gestation.Methods:The clinical data of 310 pregnant women with gestational diabetes after 28 weeks of diagnosis in Xuanwu Hospital of Capital Medical University in 2014 were retrospectively analyzed. They were divided into observation group (96 cases) with macrosomia and control group (214 cases) with normal birth weight according to the weight of newborn. The differences of BMI before pregnancy, the highest value of fasting blood glucose during pregnancy and weight gain during pregnancy between the two groups were analyzed.Results:The pre-pregnancy BMI , the highest value of random fasting blood glucose and weight gain during pregnancy in macrosomia group were significantly higher than those in non macrosomia group ( P<0.05); And the best cut-off point for predicting the delivery of macrosomia in pregnant women with gestational diabetes after 28 weeks of pregnancy was 22.077 kg/m 2, 4.965 mmol/L and 17.400 kg, respectively. The area under the curve (AUC) was 0.646, 0.595 and 0.699 respectively. After correction of confounding factors, the BMI ( OR=1.238, 95% CI 1.132, 1.354, P<0.001) and weight gain during pregnancy ( OR=1.189, 95% CI 1.120, 1.262, P<0.001) were risk factors for macrosomia in gestational diabetes mellitus after 28 weeks of gestation ( P<0.05). Conclusions:Pre-pregnancy BMI>22.077 kg/m 2, gestational maximum fasting blood glucose >4.965 mmol/L and gestational weight gain >17.400 kg were all high risk factors for gestational diabetes mellitus pregnant women after 28 weeks. For pregnant women with gestational diabetes, active prenatal intervention and health management are of great significance in reducing the risk of macrosomia.