CAJ | 학술논문

目的：探讨妊娠期糖尿病孕前体质指数（body mass indes，BMI）对围产期母婴结局的影响。方法选取2012年4月-2013年3月在海军总医院正规产检、分娩的238例妊娠期糖尿病孕妇，按照孕前 BMI 分组，BMI＜18.5 kg/m 2为低体质量组、18.5 kg/m 2≤BMI＜25.0 kg/m 2为正常组、25.0 kg/m 2≤BMI＜28.0 kg/m 2为超重组、BMI≥28.0 kg/m2为肥胖组，分析各组间早产率、巨大儿发生率、剖宫产率、新生儿出生体质量、新生儿血糖水平等围产结局，分析各组间未接受正规治疗的比例。结果各组间巨大儿发生率、剖宫产率以及未接受正规治疗的比例差异有统计学意义，其中超重组和肥胖组巨大儿发生率与正常组比较明显升高（P＜0.05），但与低体质量组比较差异无统计学意义（P＞0.05）。超重组剖宫产比例以及未接受正规治疗的比例与低体质量和正常组比较明显升高（P＜0.05），但与肥胖组比较差异无统计学意义（P＞0.05）。肥胖组孕期体质量增加以及 BMI 增加与其余3组分别比较均明显减少（P＜0.05）。超重组新生儿血糖水平与低体质量组比较明显降低（P＜0.01）。4组之间早产率、新生儿体质量差异无统计学意义（P＞0.05）。结论妊娠期糖尿病孕前 BMI 与围产期母婴结局有明显相关性，孕前将 BMI 控制在18.5～25.0 kg/m 2为宜。孕期应重点加强对孕前超重组和肥胖组的管理，控制孕期体质量增加，减少不良妊娠结局发生。
목적：탐토임신기당뇨병잉전체질지수（body mass indes，BMI）대위산기모영결국적영향。방법선취2012년4월-2013년3월재해군총의원정규산검、분면적238례임신기당뇨병잉부，안조잉전 BMI 분조，BMI＜18.5 kg/m 2위저체질량조、18.5 kg/m 2≤BMI＜25.0 kg/m 2위정상조、25.0 kg/m 2≤BMI＜28.0 kg/m 2위초중조、BMI≥28.0 kg/m2위비반조，분석각조간조산솔、거대인발생솔、부궁산솔、신생인출생체질량、신생인혈당수평등위산결국，분석각조간미접수정규치료적비례。결과각조간거대인발생솔、부궁산솔이급미접수정규치료적비례차이유통계학의의，기중초중조화비반조거대인발생솔여정상조비교명현승고（P＜0.05），단여저체질량조비교차이무통계학의의（P＞0.05）。초중조부궁산비례이급미접수정규치료적비례여저체질량화정상조비교명현승고（P＜0.05），단여비반조비교차이무통계학의의（P＞0.05）。비반조잉기체질량증가이급 BMI 증가여기여3조분별비교균명현감소（P＜0.05）。초중조신생인혈당수평여저체질량조비교명현강저（P＜0.01）。4조지간조산솔、신생인체질량차이무통계학의의（P＞0.05）。결론임신기당뇨병잉전 BMI 여위산기모영결국유명현상관성，잉전장 BMI 공제재18.5～25.0 kg/m 2위의。잉기응중점가강대잉전초중조화비반조적관리，공제잉기체질량증가，감소불량임신결국발생。
Objective To discuss the effects of pre-pregnancy body mass index (BMI) of gestational diabetes mellitus on perinatal outcomes.Methods Two hundred and thirty-eight cases of pregnant women with gestational diabetes mellitus, regularly checked-up and delivery in Navy Gene-ral Hospital during April 2012 to March 2013, were divided into four groups based on the pre-preg-nancy BMI.BMI<18.5 kg/m 2 for low body weight group, 18.5 kg/m 2≤BMI<25.0 kg/m 2 for nor-mal group, 25.0 kg/m 2≤BM<28.0 kg/m 2 for overweight group, and BMI≥28.0 kg/m 2 for obesity group, the perinatal outcomes including the preterm delivery rates, incidence of macrosomia, cesa-rean section rates, neonatal birth weight, neonatal blood glucose levels were compared between groups.The difference of accepting regular treatment rate was analyzed.Results Macrosomia rate, cesarean section and ratio to receive formal treatment were significantly different among each group. The incidence of macrosomia in the overweight group and obesity group was obviously higher than that in the normal group (P<0.05), but was almost the same with that in the low body weight group (P>0.05).The incidence of cesarean section and the ratio without formal treatment increased sig-nificantly in the overweight group than those in the low body weight and normal group (P<0.05), but was almost the same with that in the obese group(P>0.05).The weight gain and the BMI growth during the period of gestation decreased significantly in the obesity group than those in the other three groups (P<0.05).The neonatal blood glucose level was lower in the overweight group than that in the low body weight group (P<0.01).There were no significant differences between the four groups on the premature delivery rate and neonatal weight ratio(P>0.05).Conclusion The pre-pregnancy body mass index of gestational diabetes mellitus has significant correlation with the perinatal outcomes.The BMI should be controlled between 18.5- 25.0 kg/m 2 before pregnancy.We should strengthen the management on the pre-pregnancy overweight and obese groups, control the weight gain during pregnancy to reduce the adverse pregnancy outcomes.