Effects of pre-pregnancy body mass index and blood glucose level on perinatal outcomes in pregnant women with gestational diabetes mellitus
Objective:To investigate the effect of pre-pregnancy body mass index(BMI)and blood glucose level during pregnancy on perinatal outcome of pregnant women with diabetes mellitus(GDM).Methods:A total of 206 pregnant women with gestational diabetes mellitus(GDM)who gave birth in the Yellow River Sanmenxia Hospital from March 2021 to December 2023 were selected and divided into three groups based on their pre-pregnancy BMI:the low BMI group(pre-pregnancy BMI＜18.5 kg/m2),the normal group(18.5 kg/m2≤BMI＜25.0 kg/m2),and the overweight and obese group(BMI≥25.0 kg/m2),which were 23 cases,148 cases,and 35 cases,respectively.The oral glucose tolerance test(OGTT)was performed from 24 to 28 weeks of pregnancy and blood glucose levels were recorded.Also,the pregnancy outcomes of pregnant women and newborns in each group were recorded.Results:The fasting,1-hour,and 2-hour blood glucose levels in the overweight and obese group were significantly higher than those in the low BMI group and the normal BMI group(P＜0.05);The fasting,1-hour,and 2-hour blood glucose levels of pregnant women in the normal group were higher than those in the low BMI group(P＜0.05).The cesarean section rate and postpartum hemorrhage rate of overweight and obese pregnant women were significantly higher than the other two groups(P＜0.05).The proportion of premature birth,macrosomia,neonatal hypoglycemia,fetal distress,and neonatal asphyxia in the overweight and obese group was significantly higher than those in the low BMI group and normal BMI group(P＜0.05).According to the blood glucose control status,the cesarean section rate and postpartum hemorrhage rate of poorly controlled pregnant women were significantly higher than those of the ideal control group and the control group(P＜0.05).The incidence of macrosomia,premature birth,fetal distress,neonatal asphyxia,and postpartum hemorrhage in the poorly controlled group was higher than that in the ideal control group and the control group(P＜0.05).According to the classification of blood glucose control,the rate of cesarean section and the proportion of postpartum hemorrhage in the poorly controlled group were significantly higher than those in the ideal control group and the control group(P＜0.05).The incidence of macrosomia,premature delivery,fetal distress,neonatal asphyxia and postpartum hemorrhage in poor control group was higher than those in the ideal control group and control group(P＜0.05).There was no significant difference between the ideal control group and the control group(P＞0.05).Conclusions:High pre-pregnancy BMI can affect the blood glucose levels of pregnant women during pregnancy and it is one of the influencing factors affecting the perinatal outcomes of pregnant women with GDM.Effective control of blood glucose levels in GDM pregnant women can reduce complications in pregnant women and newborns,and improve the pregnancy outcomes of mothers and infants.
Gestational diabetes mellitusBlood glucoseOral glucose tolerance testBody mass index
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