青岛地区巨大儿成因及结局

Reasons and outcome analysis of macrosomia in Qingdao

【目的】分析青岛地区巨大儿发生的成因及生后生长发育趋势,为孕期指导,产后生长发育监测提供依据。【方法】以1 815例足月巨大儿为观察组,同期足月适于胎龄儿13 409例为对照。比较孕妇孕前体质指数(body massindex,BMI)、孕期增重、身高、糖代谢情况,调查膳食、运动情况,检测80例(40例巨大儿、40例适于胎龄儿)脐血瘦素、脂联素、胰岛素样生长因子-Ⅰ水平,生后3、6、9、12、18、24个月6个年龄监测点监测BMI值。【结果】观察组孕妇孕前BMI值、孕期增重、身高、糖代谢异常率明显高于对照组(χ2值分别为30.06、48.93、68.18、111.75,P<0.05)。膳食中海鲜及水果摄入量高于对照组(P<0.05)。孕期运动时间少于对照组。观察组脐血瘦素、胰岛素样生长因子-Ⅰ明显高于对照组(t值分别为4.59、5.99,P<0.01),脂联素低于对照组(t=8.42,P<0.01)。生后在各监测点观察组超重发生率高于对照组。【结论】青岛地区产妇的孕前BMI、孕期增重、孕母身高、糖代谢异常、孕期运动和饮食是巨大儿发生的成因。巨大儿有与成人肥胖相同的病理基础,结局是生后超重发生率明显增高。

【Objective】 To analyze the originated correlation factors of macrosomia as well as its correlation to obesity in Qingdao,to guide duration of pregnancy and offer accordance for monitoring postnatal growth development.【Methods】 To observe 1 815 cases of macrosomia as observational group,to compare the pregestational BMI,weight gain during pregnancy,body height,＇glycometabolism,investigating diet,exercise.The level of leptin,adiponectin,insulin-like growth factor-Ⅰin the cord blood of 80 cases（40 cases macrosomia,40 case normal） were measured by enzyme linked immunosorbent assay（ELISA）.BMI were assessed at 6 growth development to monitoring time for macrosomia and AGA.【Results】 The index of pregestational BMI,weight gain during pregnancy,body height,＇glycometabolism in observational group were much more abnormal than those in control group,and the intake of seafood and fruit in diet,the level of leptin,insulin-like growth factor-Ⅰin the cord blood,incidence rate of the overweight by assessing the BMI at postnatal monitoring point were all higher than those in the control group,while the adiponectin and movement time were lower than those in the control group.【Conclusions】 The pregestational BMI,weight gain during pregnancy,body height,glycometabolism,diet and exercise of gravida are the reasons to result in macrosomia.Macrosomia has the same pathology fundament as adults obesity,their postnatal incidence rate of overweight raise up obviously.