The impact of the number of abnormal blood glucose items,gestational weight gain and their interaction on adverse pregnancy outcomes in pregnant women
Objective To investigate the impact of the number of abnormal blood glucose items in the 24-28 week 75g oral glucose tolerance test(OGTT),gestational weight gain(GWG),and their interaction on adverse pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 404 pregnant women with GDM who underwent regular prenatal examinations and delivered at the General Hospital of Northern Theater Command from April 2020 to March 2023 were selected as the study subjects.According to the number of abnormal blood glucose items in the OGTT,the subjects were divided into groups with 1,2,and 3 abnormal items,labeled as group Ⅰ,group Ⅱ,and group Ⅲ,respectively.According to the recommendations of the Institute of Medicine(IOM)in the United States,GWG was categorized into appropriate weight gain,insufficient weight gain,and excessive weight gain groups.Differences in clinical data among the groups were compared.Logistic regression and multiplicative and additive models were used to study whether there was an interaction between the number of abnormal blood glucose items and GWG on adverse pregnancy outcomes.Results Multivariate logistic regression analysis showed that 2 or 3 abnormal blood glucose items were risk factors for hypertensive disorders of pregnancy(HDP),hypothyroidism during pregnancy,cesarean section,preterm birth,and large for gestational age(LGA)infants(aOR=3.417-8.444,P＜0.05);Three abnormal blood glucose items were risk factors for macrosomia(aOR=6.199,P＜0.05);Insufficient GWG was a risk factor for hypothyroidism during pregnancy(aOR=10.537,P＜0.05);Excessive GWG was a risk factor for HDP,cesarean section,preterm birth,macrosomia,and LGA(aOR=2.587-6.948,P＜0.05).Subgroup analysis showed that,in group Ⅰ,insufficient GWG was a risk factor for hypothyroidism and preterm birth,while excessive GWG was a risk factor for HDP and cesarean section(aOR=4.609-41.366,P＜0.05);In group Ⅱ,insufficient GWG was a risk factor for cesarean section,and excessive GWG was a risk factor for preterm birth(aOR=8.878 and 12.722,P＜0.05);In group Ⅲ,excessive GWG was a risk factor for cesarean section(aOR=38.666,P＜0.05);The multiplicative and additive interaction models indicated no interaction between ≥2 abnormal blood glucose items and unreasonable GWG on adverse pregnancy outcomes.Conclusion An increasing number of abnormal blood glucose items in the OGTT and unreasonable GWG both increase the risk of adverse pregnancy outcomes.As the number of abnormal OGTT items increases,the impact of unreasonable GWG on adverse pregnancy outcomes gradually decreases.There is no multiplicative or additive interaction between≥2 abnormal blood glucose items and unreasonable GWG on the occurrence of adverse pregnancy outcomes.
万方数据
维普
