妊娠糖尿病孕妇血糖血脂代谢对新生儿出生体质量的影响

Effect of blood glucose and lipid metabolism of pregnant women with gestational diabetes mellitus on neonatal birth weight

目的：探讨妊娠期糖尿病（GDM）孕妇血糖及血脂代谢水平对新生儿出生体质量及并发症的影响。方法2014年1月至2015年1月选取在门诊诊断为 GDM 的84例患者为研究对象，另选取同期分娩的80例正常孕妇为对照组。孕晚期测定两组血糖、血脂水平，并观察两组新生儿出生体质量及并发症。结果 GDM 组空腹血糖（FPG）、餐后2 h 血糖（2 h FBG）、血浆三酰甘油（TG）、总胆固醇（TC）、载脂蛋白 A1（ApoA1）、载脂蛋白 B（ApoB）水平显著高于对照组（P ﹤0.05）。GDM 组孕妇产前体质量（BMI）、新生儿 BMI 高于对照组（P ﹤0.05），宫内窘迫发生率、巨大儿出生率、新生儿窒息率、剖宫产率高于对照组（P ﹤0.05）。经 Pearson 单因素分析显示，新生儿 BMI与孕妇 BMI、FPG、TG、TC、ApoB 呈正相关（P ﹤0.05）。结论 GDM 孕妇血糖、血脂水平对新生儿体质量有较大的影响，孕期积极控制 GDM 孕妇血糖、血脂代谢对降低巨大儿发生有积极的作用。

Objective To investigate the effect of blood glucose and lipid metabolism on neo-natal birth weight and complications of pregnant women with gestational diabetes mellitus（ GDM）. Methods Eighty-four cases of pregnant women with GDM from January 2014 to January 2015 were se-lected as research objects,and another 80 cases of normal pregnant women were selected as control group. The levels of blood glucose and lipid of two groups were measured. The birth weight and compli-cations of neonatal of the two groups were observed. Results The levels of fasting plasma glucose （FPG）,2 h postprandial blood glucose（2 h FBG）,plasma triglyceride（TG）,total cholesterol（TC）, apolipoprotein A1（ApoA1）,apolipoprotein B（ApoB）of GDM group were higher than those of control group（P ﹤ 0. 05）. The levels of BMI of prenatal and body of GDM groups were higher than those of con-trol group（P ﹤ 0. 05）,the incidence of fetal distress,great children birth,neonatal asphyxia,caesarean section rate of GDM groups werer higher than those of control group（P ﹤ 0. 05）. The BMI of body was positively correlated with BMI of prenatal,FPG,TG,TC,ApoB（P ﹤ 0. 05）. Conclusions Blood glu-cose and lipid levels of GDM pregnant women have greater influences on weight of newborns,therefore control of blood glucose and lipid metabolism in pregnant women with GDM during pregnancy can effec-tively reduce the occurrence of fetal macrosomia.