中文摘要：

目的 探讨孕前BMI和孕中期体重增加对妊娠期糖尿病（GDM）患病的影响.方法 采用以孕妇人群作为基础的队列研究,在安徽省马鞍山市妇幼保健院围生期门诊选取首次孕期体检、孕周≤14周、马鞍山市常住户口的孕妇,首次、孕中期和孕晚期体检时分别填写问卷、测量身高和体重,在24～28周接受75 g口服糖耐量试验（OGTT）进行GDM诊断,并追踪记录分娩结局.使用t检验、方差分析、x2检验和logistic回归模型进行分析.结果 孕妇GDM的发生率为14.73％,孕前BMI与孕中期增重呈负相关（r=-0.085,P＜0.01）.GDM孕妇孕中期增重多于正常孕妇.孕妇年龄≥35岁、孕前超重和肥胖及孕早期血糖水平升高是GDM的危险因素,OR值（95％CI）分别为3.06（1.68～5.58）、2.08（1.38～3.13）、3.73（1.84 ～ 7.56）和2.17（1.57～3.00）.结论 孕前超重和肥胖以及孕期体重增加是GDM的危险因素.

英文摘要：

Objective To evaluate the associations between pregestational body mass index （BMI）,weight gain during first half of pregnancy and the risk for gestational diabetes mellitus （GDM）.Methods A prospective cohort study was conducted among 1 914 local pregnant women,receiving the first prenatal examination during the first 14 weeks of gestation,in Ma＆#39; anshan of Anhui province from May 2013 to September 2014.The body weight and height were measured for these pregnant women and questionnaire surveys were conducted among them at enrollment,middle gestation and late gestation,respectively.During 24-28 week of gestation,75 g oral glucose tolerance test was conducted for them.The independent and joint associations between pregestational BMI/weight gain and the risk of GDM were examined by using logistic regression model.Results The prevalence of GDM was 14.73%.There was significant negative correlation between pregestational BMI and weight gain during the first half of pregnancy （r=-0.085,P〈0.01）,meanwhile the weight gain of GDM women was significantly higher than that of women without GDM.The women with pregestational overweight or obesity had increased risks of GDM.The results from the logistic regression analysis showed that the risk factors included age ≥35 years （OR=3.06,95%CI：1.68-5.58）,fasting plasma glucose level during early pregnancy （OR=2.17,95% CI：1.57-3.00）,pregestational overweight （OR =2.08,95%CI：1.38-3.13）,pregestational obesity （OR=3.73,95%CI：1.84-7.56）.Conclusion Pregestational overweight or obesity and body weight gain during pregnancy were associated with increased risk of GDM.