影响巨大儿出生的危险因素分析

Analysis of Risk Factors of Fetal Macrosomia

目的探讨影响巨大儿出生的危险因素。方法随访在该院产科门诊产前检查并常规产前随诊的孕16～24周初产孕妇,检测血糖,根据糖耐量试验(OGTT)结果筛查妊娠糖尿病(Gestational Diabetes Mellitus,GDM),比较新生儿出生体重差异,并应用Logisitc回归分析巨大儿的危险因素。结果巨大儿的发病率为4.3%。单因素分析表明,年龄、孕前体重、孕前BMI、孕期增长体重、妊娠糖尿病是巨大儿的危险因素,相对危险度(odd ratio,OR)分别为1.12、1.08、1.13、4.96、2.10(P<0.05);纳入上述因素的多因素分析表明,年龄、孕前体重、孕前BMI、孕期增长体重、妊娠糖尿病是孕妇分娩巨大儿的独立危险因素,OR分别为:1.11、1.09、1.13、4.92、2.20。结论年龄、孕前BMI、孕前体重、孕期增长体重、妊娠糖尿病是孕妇分娩巨大儿的危险因素。

Objective To study the risk factors of fetal macrosomia among Chinese women in Guangzhou. Methods： 534 pregnant women were consecutively enrolled and followed for GDM from July to December in 2011. GDM was diagnosised according to the results of OGTT. Birth weights were obtained and compared between fetal macmsomia and nonfetal macrosomia group. Crude and adjusted odd ratios were calculated by logistic regression to evaluate potential risk factors associated with macrosomia. Results The prevalence of fetal macrosomia among Chinese women in Guangzhou was 3.7%. In univariate analysis, maternal age, prepregnancy weight, pre-pregnancy BMI, weight gain during pregnancy and GDM status were correlated with macrosomia. The OR were 1.12, 1.08, 1.13, 4.96 and 2.10 respectively （P〈0.05）. In multivariate analysis, maternal age, pre-pregnancy BMI, weight gain during pregnancy and GDM status were independently associated with GDM, and the OR were 1.11 , 1.09, 1.13, 4.92 and 2.20 respectively（P〈0.05）. Conclusion Maternal age, pre-pregnancy BMI, weight gain during pregnancy and GDM status were independently associated with fetal macrosomia.