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| 孕前BMI心理健康状况与妊娠期糖尿病风险的关联研究 |
| Association between pre-pregnancy BMI, psychological health, GDM risk, and glycemic metabolism |
| 投稿时间：2025-01-13 |
| DOI：10.3969/j.issn.1000-0399.2025.10.016 |
| 中文关键词: 孕前身体质量指数 心理健康 糖代谢 妊娠期糖尿病 |
| 英文关键词: Pre-pregnancy body mass index Psychological health Glycemic metabolism Gestational diabetes mellitus |
| 基金项目:铜陵市科技计划项目(编号:20230203072) |
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| 中文摘要: |
| 目的 探讨孕前身体质量指数（BMI）、心理健康状况与妊娠期糖尿病（GDM）及糖代谢的关联。方法 收集2021年1月至2023年12月在铜陵市妇幼保健院产检的3407名孕妇信息和糖代谢指标数据，通过口服葡萄糖耐量试验评价GDM发生情况，症状自评量表（SCL-90）评估心理健康状况。结果 GDM发生率为19.37%。SCL-90得分≥160分的孕妇占比为11.33%。孕前BMI增加与GDM发生风险及糖代谢指标的升高相关，呈非线性增加趋势（P均＜0.05）。孕前心理健康状况不佳（SCL-90得分≥160分）会增加GDM的发生风险（OR=1.534，95%CI：1.161~2.012，P＜0.05）；空腹血糖、餐后1小时血糖、餐后2小时血糖及葡萄糖曲线下面积随心理健康得分升高而增加，其回归系数以及95%CI分别为0.122（95%CI：0.093~0.164）、0.171（95%CI：0.032~0.313）、0.192（95%CI：0.033~0.354）和0.242（95%CI：0.023~0.461）（P均＜0.05）。在SCL-90得分≥160分的孕妇中，超重（OR=1.612，95%CI：1.143~2.203）和肥胖（OR=1.791，95%CI：1.342~2.392）的孕妇患GDM的风险高于正常体质量的孕妇（P均＜0.05）。结论 孕前BMI升高和心理健康状况不佳与妊娠期糖尿病风险及糖代谢指标升高相关，在心理健康状况不佳及肥胖孕妇人群中，关联更明显。 |
| 英文摘要: |
| Objective To explore the association between pre-pregnancy body mass index (BMI), psychological health, gestational diabetes mellitus (GDM), and glycemic metabolism indicators. Methods Data were collected from 3,407 pregnant women between January 2021 and December 2023, along with data on glycemic metabolism indicators and the occurrence of GDM. Results The incidence of GDM was 19.37%. The 11.33% of participants had SCL-90 scores exceeding 160. Pregnant women who were overweight or obese before pregnancy had a significantly higher risk of GDM and elevated glycemic metabolism indicators. The increase in pre-pregnancy BMI was significantly associated with an elevated risk of GDM and higher glycemic metabolism indicators (FPG, PG-1 h, PG-2 h, and AUC), showing a nonlinear increasing trend. Poor psychological health (SCL-90 score ≥160) was significantly associated with an increased risk of GDM, with an OR of 1.534 (95%CI: 1.161~2.012). The glycemic metabolism indicators FPG, PG-1 h, PG-2 h, and AUC significantly increased with rising psychological health scores, with β values of 0.122 (95%CI: 0.093~0.164), 0.171 (95%CI: 0.032~0.313), 0.192 (95%CI: 0.033~0.354), and 0.242 (95% CI: 0.023~0.461), respectively. The stratified analysis showed that among individuals with a score ≥160, the risk of developing GDM for overweight and obese pregnant women was 1.612 times (95%CI: 1.143~2.203) and 1.791 times (95%CI: 1.342~2.392) that of normal weight pregnant women, respectively. Conclusion Higher pre-pregnancy BMI and poor mental health status are associated with an increased risk of GDM and elevated glucose metabolism indicators, among obese women with poor mental health. |
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