妊娠期糖尿病对不同性别新生儿体脂含量差异的影响

Effect of gestational diabetes mellitus on neonatal fat mass in different gender

目的探讨母亲妊娠期糖尿病（GDM）对新生儿体脂含量影响的性别差异,为开展早期营养干预提供理论支持。方法以2015年1-7月在无锡市妇幼保健院出生的231例新生儿为研究对象,由专业人员对出生24~48h内的新生儿进行身长、体重和皮褶厚度的测量,同时使用自制调查问卷收集母亲孕期健康情况。结果 1）病例组新生儿体脂百分比和体脂含量显著高于对照组（P〈0.01）,而出生体重、身长与对照组相比差异无统计学意义（P〉0.05）。2）校正母亲孕前BMI、孕期体重增量、分娩方式、年龄、文化程度等混杂因素后,母亲妊娠期糖尿病仅是男婴出生时体脂含量的主要预测因素,病例组男婴体脂含量比对照组平均多80g（P〈0.05）。结论母亲妊娠期糖尿病对新生儿体脂含量的影响在男婴中表现更加显著。因此,应密切监测母亲孕期糖耐量异常新生儿的营养状况,尤其是针对男婴的跟踪随访和营养指导。

Objective To explore the difference in association between maternal gestational diabetes mellitus（GDM） and neonatal fat mass by sex, and to provide theoretical support for early nutrition interventions. Methods Population- based study of all neonates born to women with or without GDM （n= 231） in Wuxi Maternal and Child Health Care Hospi- tal from January to July 2015. Neonatal anthropometric measures （weight, height, skinfold thickness） were collected within 24 to 48 hours of birth by trained health staff. Self-administered questionnaires were used to collect maternal health status during pregnancy. Results 1）Compared with control group,fat mass percentage and fat mass were significant higher in the neonates of GDM mothers （P〈0.01） ,but not birth weight and length （P〉0.05）. 2）After the adjustment for maternal pre-pregnancy BMI,gestational weight gain, delivery mode, maternal age, educational level and other confounding factors, maternal gestational diabetes mellitus was the main predictor of fat mass in male newborns, but not in female offspring. There were 80 g fat mass difference in the case group than control group in male babies. Conclusions This study demonstrated that the increment of a newborn＇s fat mass related to maternal gestational diabetes mellitus appears greater for male neonates. The nutritional status of infants with maternal abnormal glucose tolerance observed in pregnancy should be closely monitored,especially for the boyff follow-up and nutritional guidance.