Читать книгу Gestational Diabetes - Группа авторов - Страница 36

Another consideration in addressing obesity and hyperglycemia is the relative frequency of the 2 conditions across entire populations of pregnant women. A number of studies have attempted to address this issue, but ascertainment bias regarding detection of hyperglycemia in pregnancy and treatment confounding due to active intervention for GDM remain major issues.

A study of 9,835 women from Southern California with a high prevalence of overweight (32%) and obesity (28%) reported that, on a population basis, overweight and obesity accounted for 21.6% of LGA infants in women without and 23.3% in women with GDM [18]. In this cohort, 75% of women who developed GDM were overweight or obese. This study also emphasized the importance of gestational weight gain (GWG) as a determinant of LGA. Similar findings have been reported by others and are clinically relevant, as GWG is potentially modifiable [19, 20]. In the global HAPO study cohort, the prevalences of overweight (22%) and obesity (14%) were much lower [21].

In summary, it is clear that, especially in populations with a high prevalence of overweight and obesity, maternal BMI contributes greatly to the population risk of LGA.