The relationship between the body mass index and the perinatal outcomes of gestational women with diabetes mellitus

CHEN Yuan-yuan; CHEN Dan-qing

Abstract：Objective To investigate the effect of maternal prepregnancy body mass index(BMI)and BMI gain during preg-nancy on obstetric outcomes of gestational diabetes mellitns (GDM) women. Methods This study is a register-based prospective cohort study. 238 pregnant women diagnosed with GDM at our institution between 2006 and 2007 were enrolled, all the women were instructed in the use of diet therapy to achieved targeted levels of glycemic control. Perinatal outcomes were observed and analyzed according to maternal prepregnancy body mass index (BMI) categories (normal weight group, overweight group,obese group)and BMI gain during pregnancy categories: A group (BMI gain <4), B group (4≤BMI gains≤6), C group (BMI gain>6). Results The rates of preeclampsia and preterm delivery in obese group (26.0%, 32.7%) were significantly higher than that in normal weight group (11.9% ,8.3%) and obese group(10.8% ,3.7%) (P <0.05). The normal weight group have less fetus distress (8.3%)than overweight group (23.5%)and obese group (23.1%)(P <0.05). In B group, there was significantly mere preeclampsia(10.4%), polyhydramnios(10.4%), pre-mature rupture of membrane (10.4%), fetus distress (11.3%), preterm delivery (8.0%) compared with the C group (22.2% ,23.8% ,25.3% ,30.2% ,30.2%). The rates of fetal macrosomia in C group (25.4%) were higher than that in A (6.0%) and B group (12.0%) (P < 0.05). The newborn of C group (28.6%) have more hypoglycemia than B group (16.0%) (P <0.05). Conclusion The obese GDM women with BMI ≥25 and BMI gain > 6 during pregnancy would have higher risk of adverse prenatal outcome such as preterm delivery, preeclampsia and fetus distress. The BMI gain during pregnancy of GDM women should be suitably controlled, and then the prenatal outcome would be enhanced.