非糖尿病性巨大儿相关因素分析

A analysis of related factors of non-diabetic fetal macrosomia

目的 探讨非糖尿病性巨大儿发生的相关因素、预防措施。方法 选择2005年6月-2006年5月在医院分娩的巨大儿92例作为研究对象,以同期诊断并治疗的胎儿出生体重〉2.5kg,〈4.0kg的25例糖耐量受损和妊娠期糖尿病作为对照,进行回顾性分析。结果 糖尿病筛查水平与胎儿出生体重无明显相关性,巨大儿孕晚期至产前双顶径、股骨长径及出生体重与糖尿病治疗组差别有显著性意义,在正常育龄妇女中第一胎发生率为80.4%。结论 孕妇孕期营养过高可能是非糖尿病性巨大儿发生的主要因素,于孕晚期通过B超监测胎儿双顶径、股骨长径,测量宫高进行筛查,对高危者及时指导孕期营养,控制体重增长,可降低巨大儿的发生。

Objective To investigate related factors and prevention of non-diabetic fetal macrosomia. Methods Ninty-two cases of non- diabetic fetal macrosomia born in our hospital over a period from May 2005 to June 2006 were selected as research subjects and twenty-five cases of IGT and GDM （2.5kg 〈 birth-weight 〈4.0kg） were as the controls in this retrospective study. Results There was not significant relation between the levels of 50g GCT and birth-weight of the newborns. The BPD, FL and birth-weight of macrosomic fetus in the third trimester of pregnancy to delivery was significantly higher than those in the diabetes treatment group and there were significant difference. The birth rate of macrosomic fetus of normal and firstly pregnant women in child-bearing age was 80.4%. Conclusion Over-nutrition may be a major factor of development of non-diabetic fetal macrosomia. The ultrasonic measurement of BPD, FL, and measurement of intrauterine height in the late pregnancy, and timely direction of nutrition during pregnancy for those high risk pregnant women can reduce the birth rate of macrosomic fetus.