妊娠期糖尿病对子代体格发育的影响分析

Influence of gestational diabetes in children physical development

目的分析妊娠期糖尿病母亲及其婴儿的体格发育情况,为制定更为科学合理的高危婴儿喂养方案提供理论依据。方法对339组妊娠期糖尿病（GDM）母亲及其新生儿进行了调查,并对其中114组婴儿在6月龄时进行了回访及体检,了解其体格发育情况。结果母亲孕期血糖控制不好是低出生体重儿的影响因素（OR=4.44,95%CI：1.69～11.69,P〈0.05）;孕前BMI和孕期体重增量是出生为巨大儿的影响因素（OR=1.18和1.11,95%CI：1.06～1.30,1.04～1.18,P〈0.05）;新生儿出生体重分别与母亲孕前BMI、孕期体重增长,以及其6月龄年龄别体重（WAZ）、年龄别BMI（BAZ）、年龄别身高（HAZ）呈正相关（P〈0.05）;孕前体质指数（BMI）、孕期体重增量、新生儿出生体重为GDM产妇剖宫产的影响因素（P〈0.05）。结论 GDM母亲子代低出生体重儿和巨大儿较多,孕期血糖控制好能减少低出生体重儿及巨大儿的发生。为预防GDM患者子代远期并发症,不仅要加强围生期保健,且从新生儿出生起就应将其纳入高危儿童管理体系,严密随访其喂养与营养状况、体格生长情况。

Objective To analyze nutritional status of women with gestational diabetes mellitus（GDM）and physical development of the offsprings of GDMs（OGDM）,and to provide theoretical support for scientific and early nutrition interventions. Methods Totally 339 women with GDM and their babies were investigated,there after 114 of them were followed up at 6months of age.The physical examinations of children were completed by trained health staff to collect growth parameters. Results Logistic regression analysis showed that after the adjustment for gender,maternal age and other confounding factors,poor glycemic control during pregnancy（OR=4.44,95%CI：1.69～11.69）was identified to be associated with low birth weight;maternal pre-pregnancy BMI（OR=1.18,95%CI：1.06～1.30）and gestational weight gain（OR=1.11,95%CI：1.04～1.18）were effect factors of macrosomia.Neonatal birth weight and maternal pre-pregnancy BMI,gestational weight gain had significant positive correlation（P0.05）;The weight-for-age Z scores（WAZ）and height-for-age Z scores（HAZ）,bmi-for-age Z scores（BAZ）at 6months were positively associated with neonatal birth weight（P0.05）.Pre-pregnancy BMI,gestational weight gain,neonatal birth weight were influencing factors of cesarean section. Conclusions OGDM had higher numbers of low birth weight and macrosomia.Ideal glycemic control during pregnancy can reduce the occurrence of low birth weight and macrosomia.To prevent long-term complications of OGDM,perinatal care should be strengthened.More importantly,these newborns should be included in the management system of high risk children from birth,their nutritional status and physical development and growth also should be closely monitored.