Correlation Between Early Gestational Weight Gain And Gestational Diabetes

Background and objective:Gestational diabetes(GDM)refers to diabetes without abnormal glucose metabolism before pregnancy.It is one of the common complications of pregnancy,which is harmful to the mother and baby,such as prolonged fetal growth,premature delivery,shoulder dystocia,etc.With the improvement of quality of life,more and more attention has been paid to nutrition during pregnancy,so that the number of pregnant women with excessive weight gain(GWG)during pregnancy has gradually increased.At present,there have been many studies on gestational weight gain and gestational diabetes,but there are few studies on the correlation between early pregnancy weight gain(GWG-F)and GDM,and the conclusions are different.This study analyzed the relationship between GWG-F and GDM,detected the relationship between the changes of inflammatory factors,insulin resistance and GDM in such patients,and provided basis for early prediction of GDM.Methods:In this study,54 pregnant women were studied in Qingdao Municipal Hospital for routine prenatal examination and delivery,including 15 GDM patients(27.8%);11 patients(19.0%)had a history of cesarean section;There were 8 patients(13.8%)with adverse pregnancy and childbirth history;There were 4 patients with family history of DM(9.6%of the total);There were 4 patients with other complications(9.6%of the total);One patient with abnormal eating habits(1.7%);The patients with CRP<0.5 and ≥0.5 were 35(60.3%)and 23(39.7%),respectively;There were 26 cases(52.0%)of spontaneous labor and 24 cases(48.0%)of cesarean section;46 patients(90.2%)had complications during pregnancy.Refer to the diagnostic criteria of GDM published by the American diabetes Association(ADA)in 2011:All pregnant women underwent a 75g oralglucosetolerancetest(oralglucosetolerancetest,75 g OGTT)at 24-28 weeks of gestation.According to the diagnostic criteria for GDM published by the AmericanDiabetesAssociation(AmericanDiabetesAssociation,ADA)in 2011 study:fasting blood glucose(fastingglucose,FPG)≥5.1mmol/L,blood glucose 1 hour after sugar(1hourplasmaglucose)≥10.0mmoL/L,2 hour blood glucose(2hourplasmaglucose)≥8.5mmol/L.GDM is diagnosed when the blood glucose value at any point reaches or exceeds the above criteria.A questionnaire survey was conducted from 12 to 14 weeks of pregnancy to collect the basic indicators of pregnant women:age,pre pregnancy BMI,eating habits,family history of diabetes,cesarean section history,history of adverse pregnancy and childbirth,pregnancy times,and birth times;At the same time,blood samples were subjected to biochemical tests,and various biochemical indicators were collected:C-reactive protein,white blood cells,neutrophils,maternal fasting blood glucose(FPG),fasting C-peptide,glycosylated hemoglobin(HbA1c),fasting insulin(FINS),triglycerides(TG),total cholesterol(TC),high-density lipoprotein(HDL),low-density lipoprotein(LDL),and insulin resistance index(HOMA-IR)was calculated by formula.First of all,univariate analysis was carried out to study the correlation between basic indicators,biochemical indicators and GDM,and meaningful indicators were included in the multivariate regression model analysis to identify the independent risk factors of GDM,and then the receiver operating characteristic curve(ROC curve)was calculated to truncate the value,so as to evaluate the predictive value of GWG-F for the onset of GDM.Results:The CRP between GDM group and control group is different(P=0.030),and the proportion of CRP ≥0.5 in GDM group(60.0%)is higher than that in control group(28.2%);The BMI of GDM group(24.11±5.02)was significantly higher than that of control group(21.99±2.57)(P=0.046);There was a difference in insulin between the control group and the GDM group(P=0.023).The insulin in the GDM group[9.79(8.23,12.78)]was higher than that in the control group[7.38(6.08,9.37)];The HOMA-IR of GDM group was different between the control group and the control group(P=0.010),and the HOMA-IR of GDM group[2.11(1.87,2.48)]was higher than that of the control group[1.39(1.11,1.99)];The GWG in early pregnancy was different between GDM group and control group(P=0.0002),and the GWG in early pregnancy in GDM group(4.37±3.34)was higher than that in control group(1.53±2.66);Multivariate regression analysis results:the higher the GWG in the early pregnancy,the greater the probability of GDM(OR=1.525,95%CI:1.112-2.092,P=0.009).Conclusions:Pre-pregnancy BMI,insulin metabolism level,CRP and GWG in early pregnancy will affect the onset of GDM;Among them,GWG in early pregnancy independently affects the onset of GDM,and may affect GDM through other bypasses;When GWG&>3.5kg in early pregnancy,the risk of GDM increased;...