妊娠期糖尿病对新生儿出生体重的影响

The impact of gestational diabetes mellitus on birth weight

目的近年来临床上加强了妊娠期糖尿病的筛查和治疗力度,诊断标准也发生改变。研究拟阐明在当前防治方案下,妊娠期糖尿病对新生儿出生体重的影响。方法选择湖北省人民医院和中南医院产科确诊为妊娠期糖尿病的536例产妇和同期入院糖耐量正常的产妇771例,比较两组新生儿中巨大儿和低体重儿发病率的差异。结果跟正常糖耐量组相比,妊娠期糖尿病组发生巨大儿(10.63%vs.4.41%)和低体重儿(12.87%vs.9.08%)的概率增高。通过Logistic回归模型校正其他变量的影响后,妊娠期糖尿病与子代发生巨大儿的风险存在显著统计学关联(OR=3.29,95%CI:2.09-5.17,P<0.001),与低出生体重的风险存在非显著统计学关联(OR=1.35,95%CI:0.94-1.94,P=0.10)。在GDM产妇中,巨大儿的母亲血糖水平显著高于正常体重儿母亲的血糖水平(P=0.01);在糖耐量正常的产妇组中,巨大儿母亲的血糖水平与正常体重儿母亲的血糖水平无显著差异(P=0.90)。结论妊娠期糖尿病导致巨大儿的风险显著增高,与妊娠期血糖水平升高有关联。

Objective To clarify the impact of gestational diabetes mellitus on the neonatal birth weight. Methods Data were collected from Hubei Renmin Hospital and Zhongnan Hospital （ Wuhan University）. A total of 536 women diagnosed with gestational diabetes were verified betw-een February 2013 and December 2016 and 771 pregnant women with nornal glucose tolerance were selected as controls. The differences of birth weight between two groups were compared. Results After multivariable adjustment, it showed that the risk of macrosomia（ OR =3. 29,95% CI ： 2. 09 - 5 . 17,P 〈0. 001） was significantly higher in GDM than in controls. The risk of low birth weight（ OR = 1. 35,95% CI： 0. 94 - 1. 94, P = 0. 10） was non-significantly higher in GDM than in controls. In GDM,the average glucose level in macrosomia＇s mother was significantly higher than that in mother of nor^mal weight neonates（ P = 0 .01 ）; In mothers ＂with normal glucose tolerance,the blood glucose level of macrosomia＇s mothers was not significantly different from that of mothers of normal birth ＂weight neonates（P =0.90）. Conclusion GDM was associated with a higher risk of macrosomia.