妊娠期糖尿病孕妇体质指数、血糖、糖化血红蛋白水平与新生儿出生体质量的关系

Relationship between body mass index,blood glucose,glycosylated hemoglobin level and neonatal birth weight in pregnant women with gestational diabetes

目的:探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇体质指数(BMI)、血糖、糖化血红蛋白(HbA1c)水平与新生儿出生体质量的关系,为减少巨大儿及不良妊娠结局的发生提供依据。方法:回顾性分析产科产前检查并住院分娩的2000例GDM孕妇(GDM组)的临床资料,并选择同期在医院产前检查并住院分娩的2000例正常孕妇作为对照组。测定两组身高、体重、血糖、糖化血红蛋白(HbA1c),并记录两组孕妇分娩时新生儿体重,对比两组孕妇体质指数、血糖、HbA1c的差异,及其与新生儿出生体质量的关系。结果:GMD组孕前BMI、空腹血糖、HbA1c、新生儿出生体质量、巨大儿均高于对照组,差异有统计学意义(P<0.05);HbA1c超标组正常体重儿比例显著低于HbA1c标准组,巨大儿比例显著高于HbA1c标准组,差异有统计学意义(P<0.05),两组低体重儿比例差异无统计学意义(P>0.05);血糖控制组正常体重儿比例显著高于血糖未控制组,巨大儿比例显著少于血糖未控制组,差异有统计学意义(P<0.05);两组低体重儿比例差异无统计学意义(P>0.05);孕妇体质量肥胖组巨大儿比例显著高于体质量过低组、正常组及超重组,正常体重儿明显低于体质量过低组、正常组及超重组,差异有统计学意义(P<0.05);体质量超重组巨大儿比例显著高于体质量过低组、正常组,正常体重儿明显低于体质量过低组、正常组,差异有统计学意义(P<0.05);四组孕妇低体重儿比例无明显差异,体质量过低组和体质量正常组孕妇新生儿出生体质量无明显差异,以上差异均无统计学意义(P>0.05);对GDM孕妇体质量指数、血糖、糖化血红蛋白水平与新生儿出生体质量进行相关性分析,结果显示,孕妇孕前BMI、HbA1c、空腹血糖与新生儿体质量呈显著正相关(r=0.462、0.571、0.389,P<0.05)。结论:GDM孕妇孕前BMI过高、空腹血糖过高、HbA1c水平超标均是造成新生儿巨大儿的高危因素,GDM孕妇孕前BMI、空腹血糖、HbA1c水平均与新生儿出生体质量有着密切关系。

Objective To investigate the relationship between body mass index,blood glucose,glycosylated hemoglobin level and birth weight in pregnant women with gestational diabetes mellitus(GDM),and to provide evidence for reducing the incidence of macrosomia and adverse pregnancy outcomes.Method Retrospective analysis of clinical data of 2000 GDM pregnant women(GDM group)who were prenatally examined and hospitalized in the obstetrics department,and 2000 prenatal examinations and hospital delivery were selected.A normal pregnant woman was used as a control group.Height,weight,blood glucose,glycosylated hemoglobin(HbA1c)were measured,and the weight of newborns at the time of delivery was recorded.The differences in body mass index,blood glucose and HbA1c between the two groups and their relationship with birth weight were compared.Results The pre-pregnancy BMI,fasting blood glucose,HbA1c,neonatal birth weight,and macrosomia were significantly higher in the GMD group than in the control group(P<0.05).The proportion of normal weight children in the HbA1c over-standard group was significantly lower than that in the HbA1c standard group.The proportion of children was significantly higher than that of HbA1c standard group(P<0.05).There was no significant difference in the proportion of low birth weight children between the two groups(P>0.05).The proportion of normal weight children in blood glucose control group was significantly higher than that of blood glucose control.Group,the proportion of giant children was significantly less than that of uncontrolled blood glucose,the difference was statistically significant(P<0.05);there was no significant difference in the proportion of low birth weight infants between the two groups,compared with no statistical significance(P>0.05);The proportion of large children was significantly higher than that of low body mass,normal group and super recombination.Normal weight children were significantly lower than those with low body mass,normal group and super recombination.The difference was statistically significant(P<0.05);body mass The proportion of super-recombinant giants was significantly higher than that of the low-quality group and the normal group.The normal weight children were significantly lower than the low-weight group and the normal group.The difference was statistically significant(P<0.05).The proportion of low-weight children in the four groups of pregnant women No significant difference There was no significant difference in the birth weight of pregnant women between the low body mass group and the normal body mass group,which was not statistically significant(P>0.05).The body mass index,blood glucose,glycosylated hemoglobin level and neonatal birth weight of GDM women.Correlation analysis showed that there was a significant positive correlation between prenatal BMI,HbA1c,fasting blood glucose and neonatal body weight(r=0.462,0.571,0.389,P<0.05).Conclusion Pre-pregnancy BMI,high fasting hyperglycemia and excessive HbA1c levels in GDM pregnant women are high risk factors for neonates.The pre-pregnancy BMI,fasting blood glucose and HbA1c levels in GDM pregnant women are closely related to neonatal birth weight.