Objective: This study aimed to compare the incidence of gestational diabetes mellitus (GDM) in older underweight pregnant women vs young overweight/obese ones.
Methods: A multiracial retrospective-cohort study was conducted in five hospitals of Shanghai on 7,485 women who had been pregnant during 2018– 2020. Incidence of GDM was equal to the proportion of GDM cases in the total number of cases observed in the same period. Comparison of GDM incidence of older underweight pregnant women and young overweight/obese ones was done with χ² tests. ORs and 95% CIs for GDM were estimated using univariate and multivariate logistic regression across gestation age and prepregnancy BMI.
Results: Advanced age (OR 1.09, 95% CI 1.072– 1.11; P=0) and higher BMI (OR 1.57, 95% CI 1.112– 2.212; P=0.01) were found to be risk factors of GDM. The incidence of 13.33% of older underweight pregnant women (age ≥ 35years, BMI < 18.5 kg/m²) developing GDM was lower than that of young overweight/obese ones (age ≤ 24 years, BMI ≥ 24 kg/m²). For those aged ≥ 35years, it is advised that BMI be kept to < 18.5 kg/m². For those aged ≤ 24 years, BMI control should not exceed 24 kg/m².
Conclusion: Older underweight (age≥ 35years, BMI < 18.5 kg/m²) pregnant women beat young overweight/obese ones (age ≤ 24 years, BMI ≥ 24 kg/m²) on incidence of GDM. Factors influencing obesity/overweight in GDM were high maternal age, though being young is a promising protective factor for GDM and tolerance of BMI is promoted, but should be limited to certain ranges. Being older increased the chances of developing GDM, but those with lower BMI still had lower GDM incidence than younger pregnant women.

Keywords: gestational diabetes mellitus, GDM, prepregnancy body-mass index, pre-BMI, pregnancy outcome


中文翻译：

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老年体重不足的孕妇在妊娠期糖尿病发病率方面击败了年轻的超重/肥胖孕妇

目的：本研究旨在比较年长体重不足的孕妇与年轻超重/肥胖孕妇的妊娠糖尿病 (GDM) 发病率。
方法：在上海市5家医院对2018-2020年期间怀孕的7485名妇女进行多种族回顾性队列研究。GDM的发生率等于同期观察的GDM病例总数的比例。年龄过轻孕妇和年轻超重/肥胖孕妇的 GDM 发生率比较采用 χ2^检验。使用跨孕龄和孕前 BMI 的单变量和多变量逻辑回归估计 GDM 的 OR 和 95% CI。
结果：高龄（OR 1.09，95% CI 1.072–1.11；P=0) 和较高的 BMI (OR 1.57, 95% CI 1.112–2.212; P = 0.01) 被发现是 GDM 的危险因素。13.33%的老年体重不足孕妇（年龄≥35岁，BMI < 18.5 kg/m ²）发生GDM的发生率低于年轻超重/肥胖孕妇（年龄≤24岁，BMI ≥ 24 kg/m ²）。对于年龄≥35岁的人，建议BMI保持在<18.5 kg/m ²。对于年龄≤24岁的人，BMI控制不应超过24 kg/m ²。
结论：老年体重不足（年龄≥35岁，BMI < 18.5 kg/m ²）孕妇优于年轻超重/肥胖者（年龄≤24岁，BMI ≥ 24 kg/m ²) 关于 GDM 的发病率。影响 GDM 肥胖/超重的因素是高龄产妇，虽然年轻是 GDM 的一个有希望的保护因素，提高了对 BMI 的耐受性，但应限制在一定范围内。年龄较大会增加患 GDM 的机会，但 BMI 较低的孕妇的 GDM 发病率仍低于年轻孕妇。

关键词：妊娠糖尿病，GDM，孕前体重指数，孕前BMI，妊娠结局