脐带瘦素水平与胎儿生长发育及新生儿出生体质量的临床研究

Clinical study on umbilical cord leptin levels associated with fetal growth and neonatal birth weight

目的：探讨脐带瘦素水平与胎儿生长发育及新生儿出生体质量的关系。方法选择2009年2月至2013年6月在商丘市第一人民医院分娩的142例新生儿，按照出生体质量与胎龄关系的不同分为3组。A 组（小于胎龄儿，出生体质量在相同胎龄平均体质量的第10百分位以下）44例，男23例，女21例；B 组（适于胎龄儿，出生体质量在相同胎龄平均体质量的第10~90百分位）56例，男30例，女26例；C 组（大于胎龄儿，出生体质量在相同胎龄平均体质量的第90百分位以上）42例，男22例，女20例。对比3组新生儿体质量指数、出生体质量、胎盘重量及脐带瘦素水平。结果 A 组新生儿体质量、新生儿体质量指数、胎盘重量、新生儿身长及瘦素水平明显低于 B 组（P 均﹤0.001）；C 组新生儿体质量、新生儿体质量指数、胎盘重量、新生儿身长及瘦素水平明显高于 B 组（P 均﹤0.001）。男婴组新生儿出生体质量明显高于女婴组（P ﹤0.001）；男婴组新生儿瘦素水平明显低于女婴组（P ﹤0.001）。脐带瘦素水平与新生儿出生体质量、新生儿身长、新生儿体质量指数及胎盘重量等指标均呈正相关（r =0.382、0.276、0.358、0.412，P 均﹤0.01）。结论脐带瘦素水平与胎儿宫内生长发育及新生儿出生体质量密切相关，可作为反映宫内生长发育及新生儿出生体质量的重要指标之一。

Objective To study the relationship between umbilical cord leptin levels and fetal growth as well as neonatal birth weight. Methods One hundred and forty - two neonates selected from February 2009 to June 2013 in Shangqiu First People＇s Hospital according to the different gestational age and birth weight were divided into 3 groups. Group A included 44 cases（small for gestational age,birth weight below the average weight of the 10th percentile at the same gestational age）,23 boy cases,21 girl cases;group B included 56 cases（appropriate for gestational age,birth weight at the average weight of the 10th to 90th percentile at the same gestational age）,30 boy cases,26 girl cases;group C included 42 cases（large for gestational age,birth weight above the average weight of the 90th percentile at the same gestational age）,22 boy cases,20 girl cases. Neonatal body mass index,birth weight,placenta weight and umbilical lep-tin levels of three groups were compared. Results Neonatal birth weight,neonatal body length,body mass index and the placenta weight leptin levels in group A were significantly lower than those of group B,having statistically significant difference（all P ﹤ 0. 001）;Neonatal birth weight,neonatal body length,body mass index and the placenta weight leptin levels in group C were significantly higher than those in group B,with statistically significant difference（ all P ﹤0. 001）. Neonatal birth weight in the boy group was obviously higher than that of the girl group,and the difference was statistically significant（P ﹤ 0. 001）. Neonatal leptin levels in the boy group were significantly lower than that of the girl group,and the difference was statistically significant（P ﹤ 0. 001）. There were positive correlations between the umbili-cal cord leptin levels and the neonatal birth weight,neonatal length,neonatal weight index and the placenta weight（r =0. 382,0. 276,0. 358,0. 412,all P ﹤ 0. 01）. Conclusions The umbilical cord leptin levels are closely associated with neonatal birth weight and intrauterine growth retardation,and it can be used as one of the important indicators for reflec-ting neonatal birth weight and fetal growth.