高龄孕妇糖代谢异常与新生儿出生体重的关系

Association between neonatal birth weight and abnormal glucose metabolism of pregnant women at advanced age

目的探讨35岁以上高龄孕妇糖代谢异常特点与新生儿出生体重的关系。方法本研究纳入2017年1月1日~12月31日医院确诊为妊娠期糖尿病且年龄≥35岁的851名符合条件的孕妇作为研究对象,根据血糖异常的类型分组,比较糖代谢异常类型和各组间新生儿出生体重的差异,同时利用多元回归分析模型建立影响新生儿出生体重的预测模型。结果单纯糖耐量受损组新生儿出生体重最低(P<0.05)。孕周和孕期体重增加与新生儿出生体重呈正相关(P<0.05)。在出生体重的不同预测模型中,空腹血糖,血糖异常的类型和程度,均为出生体重的独立预测因子,标准回归系数分别为0.20,0.22和0.18。结论高龄GDM孕妇的不同血糖异常特点(包括类型和程度)对新生儿出生体重的影响不尽相同,医疗机构应结合GDM孕妇孕期不同糖代谢特点,对孕妇进行分层管理和早期干预,以减少与出生体重相关的不良妊娠结局,促进母婴健康。

Objective To explore the association between neonatal birth weight and characteristics of abnormal glucose metabolism of pregnant women aged over 35 years.Methods In this study,a total of 851 eligible pregnant women(age:≥35)who were diagnosed with gestational diabetes mellitus(GDM)in our hospital from January 1,2017 to December 31,2017 were enrolled as subjects and divided into different groups based on the types of abnormal glucose.The types of abnormal glucose metabolism and neonatal birth weight among each group were compared,and multiple regression analysis models were used to establish the prediction models for neonatal birth weight.Results The group of isolated impaired glucose tolerance(IGT)had the lowest neonatal birth weight(P<0.05).Gestational age and weight gain during pregnancy were positively correlated with neonatal birth weight(P<0.05).Among the different prediction models for birth weight,the fasting blood-glucose along with the types and degrees of abnormal glucose were used as the independent predictors of birth weight,with the standard regression coefficients of 0.20,0.22 and 0.18,respectively.Conclusion For pregnant women with GDM at advanced age,characteristics of abnormal glucose(including type and degree)had different effects on the neonatal birth weight.Therefore,the medical institutions should combine the characteristics of different glucose metabolisms of pregnant women with GDM during pregnancy and implement hierarchical management and early intervention for pregnant women,so as to reduce adverse pregnancy outcomes related to birth weight and promote maternal and child health.