妊娠期糖尿病及孕中期血糖水平与新生儿出生体质量的关联研究:基于出生人口队列

Association of gestational diabetes mellitus and blood glucose level during the second trimester with neonatal birth weight: A study based on birth cohort

目的探究中国西北地区妊娠期糖尿病及血糖水平与新生儿出生体质量的关系。方法连续纳入2018年7月-2019年7月加入西北妇女儿童医院出生人口队列的孕早期孕妇,收集其基本人口学特征、生活行为方式等资料,并对研究对象的口服葡萄糖耐量试验(OGTT)结果和妊娠结局进行随访,采用广义线性模型分析妊娠期糖尿病及血糖水平对新生儿出生体质量的影响。结果本研究共纳入了2 422名研究对象,其中656(27.09%)名孕妇孕期发生妊娠期糖尿病。孕妇患有妊娠期糖尿病增加了新生儿出生体质量(β=50.00,95%CI:17.48~82.51)、体质量Z值(β=0.11,95%CI:0.03~0.19)及体质量Z Centile值(β=3.22,95%CI:0.88~5.55),且会增加巨大儿(OR=1.54,95%CI:1.04~2.28)的发生风险。孕中期空腹血糖值异常会增加巨大儿及大于胎龄儿的发生风险;随着孕中期OGTT血糖值的升高,出生体质量增高、巨大儿及大于胎龄儿的发生率均呈上升趋势。结论孕妇罹患妊娠期糖尿病可能增加新生儿出现出生体质量增高及巨大儿的发生风险,应积极控制妊娠期糖尿病患者的血糖水平,促进母婴健康。

Objective To explore the association of gestational diabetes mellitus(GDM) and blood glucose level with birth weight of the newborns in Northwest China. Methods Pregnant women in their first trimester who joined the birth cohort of Northwest Women and Children’s Hospital from July 2018 to July 2019 were consecutively enrolled. We collected their basic demographic characteristics, lifestyle behavior and other data. We followed up the results of the OGTT test and pregnancy outcomes. The generalized linear model was used to analyze the effects of GDM and blood glucose levels on the birth weight of newborns. Results A total of 2 422 subjects were included in this study, and 656(27.09%) pregnant women had GDM during pregnancy. Pregnant women with GDM increased the birth weight(β=50.00, 95% CI: 17.48-82.51), Z-value(β=0.11, 95% CI: 0.03-0.19) and Z Centile value(β=3.22,95% CI:0.88-5.55),and increased the risk of macrosomia(OR=1.54,95% CI:1.04-2.28).Abnormal FPG value during the second trimester would increase the risk of macrosomia and LGA.With the increase of OGTT blood glucose value in the second trimester,the birth weight value and the incidence of macrosomia and LGA showed an upward trend.Conclusion Pregnancy in women with GDM might increase the birth weight of newborns and the risk of macrosomia,especially FPG.We should vigorously control the blood glucose level of GDM patients to promote the health of mothers and infants.