Relationship Between Maternal Second Trimester Central Obesity And The Risk Of Gestational Diabetes Mellitus

Objective:Gestational diabetes mellitus(GDM)has affected 5–15% pregnancies in the world and is one of the most common diseases of pregnancy.Central obesity can reflect fat distribution or the proportion of adipose to non-adipose tissue,to evaluate the relationship of maternal second trimester central obesity with the risk of pregnancy complications.There are few studies on the relationship between maternal central obesity and the risk GDM in China.We studied an epidemiology investigation to evaluate the relationship of maternal second trimester central obesity with the risk of GDM.These findings can strengthen the scientific background for public health interventions for the control of maternal central obesity independent of BMI.Methods:This study was a prospective cohort study in northeast China.In this study,716 pregnant women who came to shengjing hospital for 75 g oral glucose tolerance test(OGTT)were included in the survey.The inclusion criteria were 24-28 weeks pregnant women;age ≥20 years;volunteer to participate in the study and sign the informed consent.Questionnaires were used to collect basic information(including age,occupation,etc.;previous history: childbearing history,etc.;personal life history: smoking,drinking,etc.);Collecting physical examination information;Collecting body composition measurement: weight,BMI,fat mass,etc.;and summarize the measurement values.OGTT results of pregnant women at 24-28 weeks were collected to determine whether pregnant women had GDM.The analysis was performed using SPSS19.0 to evaluate the association of maternal second trimester central obesity with the risk of GDM.Results:In this study,the prevalence of GDM was 22.91%.The average age of participated pregnant women was 30.80±3.75,and the average gestational age was 25.57±1.21.There were 98 pregnant women aged above 35 years,59.64% unipara women,7.68% had a family history of diabetes.Compared with the non-GDM group,age,pre-pregnancy and second trimester body mass index(BMI),fat mass,body fat percentage(FMP),muscle mass,fat-to-lean mass(FyM)and drinking history were statistically significant.Spearman correlation analysis showed that BMI,fat mass,FMP,Fy M during pregnancy were positively correlated with GDM.The results of logistic regression analysis showed that pre-pregnancy and second trimester women overweight or obesity was correlated with GDM,and the adjusted OR was 1.78(95%CI:1.18～2.67),2.06(95%CI:1.23～3.46),1.78(95%CI:1.18～2.71),2.13(95%CI:1.07～4.27);the adjusted OR of fat mass,FMP and Fy M was 4.41(95%CI:2.44～9.97),2.25(95%CI:1.32～3.85),4.34(95%CI:2.41～7.82).ROC curve analysis showed that the under curve area of pre-pregnancy and pregnancy BMI,FMP,fat mass,Fy M were greater than 0.5(P < 0.05),which was statistically significant for the diagnosis of GDM.Conclusion : 1.In this study,the prevalence of GDM was 22.91%.2.Pre-pregnancy and second trimester women overweight and obesity,fat mass,FMP and Fy M were significantly the risk factors of GDM.3.Our findings indicate that the risk of GDM was positively associated with maternal second trimester central obesity.These findings can strengthen the scientific background for public health interventions for the control of maternal central obesity independent of BMI.