Analysis of Maternal and Infant Outcomes of Pregnant Women with Gestational Diabetes Mellitus_West China Medical Journal

Authors：

 JingXiaofan ¹ , LiuYuan ¹ , RaoZhiyong ¹ , DaiTingting ¹ , LiXuemei ¹ , PuFangfang ¹ ,  HuWen ¹ , QiaoRong ²

1. Department of Clinical Nutrition, West China Hospital;
2. Nutrition Room, West China Second University Hospital;Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

HuWen, Email: wendy_nutrition@163.com

Keywords：

Gestational diabetes mellitus; Diet during pregnancy; Weight gain during the pregnancy; Pregnant outcomes

DOI：

10.7507/1002-0179.20160080

Video：

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Objective To explore the relationship between the diet during pregnancy and gestational diabetes mellitus (GDM), and analyze the effect of GDM on weight gain, outcome and complication of mother and infant. Methods We selected 128 GDM pregnant women and 267 non-GDM pregnant women who were investigated by semi-quantitative food frequency method during September 2009 to March 2011. Then, we collected relevant information and the data were analyzed by t-test and chi-square test. Results There were statistically significant differences between the two groups in total calorie, carbohydrate, fat and protein intakes per day (P<0.05). In general, the rates of insufficient weight gain and excessive weight gain during pregnancy in the GDM group were significantly higher than the non-GDM group (P<0.05), while proper weight gain rate was significantly lower (P<0.01). The risk of hydramnion, intrahepatic cholestasis and pregnancy-induced hypertension in the GDM group was significantly higher than the non-GDM group (P<0.05), while there was no significant difference between the two groups in premature delivery, cesarean section or premature membrane ruptures (P>0.05). Apgar scores were significantly different at minute 1 and 5 between the infants in the two groups (P<0.05). The incidence of fetal death, malformation, mild neonatal asphyxia and fetal macrosomia in the GDM group was significantly higher than the non-GDM group (P<0.05). No significant differences between the two groups in low birth weight infant, cord entanglement and fetal distress were detected (P>0.05). Conclusion GDM can lead to high incidence of poor outcome and complication. It is vital to strengthen the examination and keep balanced dietary structure, in order to reduce the complication and improve the health of mother and child.

Citation： JingXiaofan, LiuYuan, RaoZhiyong, DaiTingting, LiXuemei, PuFangfang, HuWen, QiaoRong. Analysis of Maternal and Infant Outcomes of Pregnant Women with Gestational Diabetes Mellitus. West China Medical Journal, 2016, 31(2): 301-305. doi: 10.7507/1002-0179.20160080 Copy

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2.	尹玉竹, 谌小卫, 李小毛, 等. 孕前体重、孕期增重与妊高征及新生儿出生体重的关系[J]. 第一军医大学学报, 2005, 25(2):226-228.
3.	武洁姝, 荫士安. 孕期体重增长与妊娠结局[J]. 中华围产医学杂志, 2005, 8(4):282-284.
4.	乐杰. 妇产科学[M]. 7版. 北京:人民卫生出版社, 2008.
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6.	Reece EA. The fetal and maternal consequences of gestational diabetes mellitus[J]. J Matern-Fetal Neonatal Med, 2010, 25(3):199-203.
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9.	Institute of Medicine. Nutrition during pregnancy:partⅠ:weight gain, partⅡ:Nutrient supplements[M]. Washington DC:National Academy Press, 1990.
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11.	Dennedy MC, Dunne F. The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome[J]. Best Pract Res Clin Endocrinol Metab, 2010, 24(4):573-589.
12.	Stuebe AM, Forman MR, Michels KB. Maternal-recalled gestational weight gain, pre-pregnancy body mass index, and obesity in the daughter[J]. Int J Obes, 2009, 33(7):743-752.
13.	刘郑洁. 妊娠期糖代谢异常对妊娠结局的影响[J]. 中国妇幼保健, 2010, 25(17):2345-2346.
14.	Yogev Y, Xenakis EM, Langer O. The association between preeclampsia and the severity of gestational diabetes:the impact of glycemic control[J]. Am J Obstet Gynecol, 2004, 191(5):1655-1660.
15.	Vambergue A, Nuttens MC, Goeusse P, et al. Pregnancy induced hypertension in women with gestational carbohydrate intolerance:the diagest study[J]. Eur J Obstet Gynecol Reprod Biol, 2002, 102(1):31-35.
16.	何冰, 李书琴, 王伟, 等. 妊娠期糖尿病患者妊娠晚期血脂水平变化与新生儿出生体重的关系[J]. 中华妇产科杂志, 2004, 39(10):675-677.
17.	Setji TL, Brown AJ, Feinglos MN. Gestational diabetemellitus[J].Clin Diabet[J], 2005, 23(1):17-24.
18.	杨慧霞. 妊娠合并糖尿病对孕妇和围产儿的影响[J]. 中华医学信息导报, 2005, 20(3):14-15.
19.	马向东, 陈必良, 辛晓燕, 等. 妊娠合并糖尿病诱发胚胎先天性神经管缺陷的MAP激酶及细胞凋亡信号传导机制[J]. 现代妇产科进展, 2003, 12(5):324-326, 335.
20.	Barahona MJ, Sucunza N, García-Patterson A, et al. Period of gestational diabetes mellitus diagnosis and maternal and fetal morbidity[J]. Acta Obstet Gynecol Scand, 2005, 84(7):622-627.
21.	Melamed N, Hod M. Perinatal mortality in pregestational diabetes[J]. Int J Gynaecol Obstet, 2009, 104 (Suppl 1):S20-S24.
22.	杜晓红, 罗红权, 常军. 控制血糖对改善妊娠期糖尿病孕妇妊娠结局的意义[J]. 实用妇产科杂志, 2008, 24(8):501-503.
23.	Greene MF, Solomon CG. Gestational diabetes mellitus-time to treat[J]. N Engl J Med, 2005, 352(24):2544-2546.
24.	李娟, 李和江. 孕期心理干预对妊娠结局的影响[J]. 中国妇幼保健, 2010, 25(16):2199-2200.

1. Zhang F, Dong L, Zhang CP, et al. Increasing prevalence of gestational diabetes mellitus in Chinese women from 1999 to 2008[J]. Diabet Med, 2011, 28(6):652-657.
2. 尹玉竹, 谌小卫, 李小毛, 等. 孕前体重、孕期增重与妊高征及新生儿出生体重的关系[J]. 第一军医大学学报, 2005, 25(2):226-228.
3. 武洁姝, 荫士安. 孕期体重增长与妊娠结局[J]. 中华围产医学杂志, 2005, 8(4):282-284.
4. 乐杰. 妇产科学[M]. 7版. 北京:人民卫生出版社, 2008.
5. 周敏, 章小维, 渠川琰, 等. 妊娠期适宜增重范围与出生体重的关系研究[J]. 中国实用妇科与产科杂志, 2007, 23(4):275-277.
6. Reece EA. The fetal and maternal consequences of gestational diabetes mellitus[J]. J Matern-Fetal Neonatal Med, 2010, 25(3):199-203.
7. 杨月欣. 中国食物成分表2004[M]. 北京:北京大学医学出版社, 2005.
8. 李艳平, 何宇纳, 翟凤英, 等. 称重法、回顾法和食物频率法评估人群食物摄入量的比较[J]. 中华预防医学杂志, 2006, 40(4):273-280.
9. Institute of Medicine. Nutrition during pregnancy:partⅠ:weight gain, partⅡ:Nutrient supplements[M]. Washington DC:National Academy Press, 1990.
10. Rosenberg TJ, Garbers S, Lipkind H, et al. Maternal obesity and diabetes as risk factors for adverse pregnancy outcomes:differences among 4 racial/etbnic groups[J]. Am J Public Health, 2005, 95(9):1545-1551.
11. Dennedy MC, Dunne F. The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome[J]. Best Pract Res Clin Endocrinol Metab, 2010, 24(4):573-589.
12. Stuebe AM, Forman MR, Michels KB. Maternal-recalled gestational weight gain, pre-pregnancy body mass index, and obesity in the daughter[J]. Int J Obes, 2009, 33(7):743-752.
13. 刘郑洁. 妊娠期糖代谢异常对妊娠结局的影响[J]. 中国妇幼保健, 2010, 25(17):2345-2346.
14. Yogev Y, Xenakis EM, Langer O. The association between preeclampsia and the severity of gestational diabetes:the impact of glycemic control[J]. Am J Obstet Gynecol, 2004, 191(5):1655-1660.
15. Vambergue A, Nuttens MC, Goeusse P, et al. Pregnancy induced hypertension in women with gestational carbohydrate intolerance:the diagest study[J]. Eur J Obstet Gynecol Reprod Biol, 2002, 102(1):31-35.
16. 何冰, 李书琴, 王伟, 等. 妊娠期糖尿病患者妊娠晚期血脂水平变化与新生儿出生体重的关系[J]. 中华妇产科杂志, 2004, 39(10):675-677.
17. Setji TL, Brown AJ, Feinglos MN. Gestational diabetemellitus[J].Clin Diabet[J], 2005, 23(1):17-24.
18. 杨慧霞. 妊娠合并糖尿病对孕妇和围产儿的影响[J]. 中华医学信息导报, 2005, 20(3):14-15.
19. 马向东, 陈必良, 辛晓燕, 等. 妊娠合并糖尿病诱发胚胎先天性神经管缺陷的MAP激酶及细胞凋亡信号传导机制[J]. 现代妇产科进展, 2003, 12(5):324-326, 335.
20. Barahona MJ, Sucunza N, García-Patterson A, et al. Period of gestational diabetes mellitus diagnosis and maternal and fetal morbidity[J]. Acta Obstet Gynecol Scand, 2005, 84(7):622-627.
21. Melamed N, Hod M. Perinatal mortality in pregestational diabetes[J]. Int J Gynaecol Obstet, 2009, 104 (Suppl 1):S20-S24.
22. 杜晓红, 罗红权, 常军. 控制血糖对改善妊娠期糖尿病孕妇妊娠结局的意义[J]. 实用妇产科杂志, 2008, 24(8):501-503.
23. Greene MF, Solomon CG. Gestational diabetes mellitus-time to treat[J]. N Engl J Med, 2005, 352(24):2544-2546.
24. 李娟, 李和江. 孕期心理干预对妊娠结局的影响[J]. 中国妇幼保健, 2010, 25(16):2199-2200.

West China Medical Journal

Analysis of Maternal and Infant Outcomes of Pregnant Women with Gestational Diabetes Mellitus

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