妊娠期糖尿病母亲的适于胎龄儿婴儿期生长发育模式

Growth patterns of appropriate for gestational age infants of gestational diabetic mothers during the first year

目的 探讨妊娠期糖尿病（GDM）母亲的适于胎龄儿（AGA）子代婴儿期的生长发育模式.方法 本研究以2011年1至12月在昆明医科大学第一附属医院分娩的AGA婴儿为研究对象.以GDM孕妇所生的AGA为GDM组,共70例,其中男36例（51.4％）,女34例（48.6％）;以非GDM孕妇所生的AGA为对照组,共154例,其中男66例（42.9％）,女88例（57.1％）.两组AGA婴儿出生后定期在3、6、12月龄时进行体重及身长测量,计算体质指数（BMI）,评价其生长速度,并对两组资料进行比较.结果 GDM组AGA男婴在3、6月龄时体重、身长及BMI均小于对照组AGA男婴,12月龄时GDM组AGA男婴体重、身长及BMI均大于对照组AGA男婴,但差异无统计学意义（P＞0.05）.GDM组AGA男婴0～3个月及3～6个月体重增长值及身长增长值均低于非糖尿病母亲的AGA子代男婴,其中3～6个月两组差异有统计学意义[（1.1±0.4）比（1.4±0.4）kg,P=0.040;（4.9±2.3）比（6.3±1.2）cm,P=0.026];GDM组AGA男婴6～12个月体重增长值与身长增长值均高于对照组AGA男婴,但差异无统计学意义[（2.1±0.5）比（1.8±0.5）kg,P=0.361;（8.4±1.3）比（7.8±1.4）cm,P=0.464].结论 GDM子代男婴在出生后0～6个月生长迟滞,随后出现生长追赶,提示GDM孕妇宫内高血糖环境对胎儿的影响可能延续到了出生后的早期.

Objective To explore the growth pattern of appropriate for gestational age （AGA） infants of mother with gestational diabetes mellitus （GDM）.Methods The objects of this study were offspring of women who delivered in our hospital from January to December 201 1.The GDM group included 70 AGA infants （36 male cases and 34 female cases） of mother with GDM.The control group included 154 AGA infants （66 male cases and 88 female cases） of women with normal glucose tolerance.The data of demographic characteristics of mothers of two groups were collected.Body weight and length of infants in two groups were measured at 3,6 and 12 months age respectively.Body mass index （BMI）,weight and height gain during infancy （0-3 months,3-6 months and 6-12 months） of infants in two groups were also calculated.Results Body weight,length and BMI of male AGA infants in GDM group were less than that of control group at 3 months and 6 months age,but more than that of control group at 12 months age,however,there were no significant differences between two group （P 〉 0.05）.The weight and height gain during infancy （0-3 months,3-6 months） of male AGA infants in GDM group were lower than that of control group,but the difference was statistically significant only at 3-6 months[（1.1 ±0.4） vs （1.4 ±0.4） kg,P =0.040;（4.9 ± 2.3） vs （6.3 ± 1.2） cm,P =0.026].The weight and height gain during infancy （6-12 months） of male AGA infants of gestational diabetic mothers were higher than that of control group,but the difference was not statistically significant[（2.1 ± 0.5） vs （1.8 ± 0.5） kg,P =0.361;（8.4 ± 1.3） vs （7.8 ± 1.4） cm,P =0.464].Conclusion Male infants of gestational diabetic mothers grew slowly during their infancy of 0-6 months,and then their growth became increasingly fast,which suggested that the influence of intrauterine hyperglycemia environment of GDM mothers on fetal growth might continue after birth.