妊娠期糖尿病产妇分娩巨大儿相关因素分析

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摘要目的探讨妊娠期糖尿病发生巨大儿的相关因素。方法将174例妊娠期糖尿病产妇根据新生儿出生体重分为两组,分娩巨大儿组(新生儿出生体重≥4 000 g)28例,分娩正常体重组(新生儿出生体重2 500～3 999 g)146例。同时收集19例分娩巨大儿的健康产妇(对照组)。对分娩前1周内的一般情况及相关因素(包括年龄、孕前体重指数、孕期体重增长、入院空腹血糖值、糖化血红蛋白、糖化白蛋白值等)进行回顾性分析。结果 GDM-巨大儿组孕前BMI、孕期体重增长、糖化血红蛋白值高于GDM-正常儿组,差异有统计学意义。GDM-巨大儿组年龄、空腹血糖、糖化血红蛋白、糖化白蛋白高于对照组,差异有统计学意义。GDM-正常儿组的GA与HbA1c呈线性正相关(r=0.3)。GDM-巨大儿组GA与HbA1c呈线性正相关(r=0.7);HBA1c与新生儿BMI呈正相关(r=0.4)。GDM-巨大儿组未接受治疗的比率高于GDM-正常儿组,饮食运动疗法和饮食运动疗法+胰岛素的比率低于GDM-正常儿组,差异有统计学意义;GDM-巨大儿组血糖控制满意率低于GDM-正常儿组,差异有统计学意义。结论影响妊娠期糖尿病产妇新生儿出生体重的因素是多重的,特别是针对孕前体型超重、孕期体重增长过多的孕妇更应加强孕期健康宣传教育及高危监测管理,控制其体重增长,预防巨大儿的发生。孕期使用积极的方式控制血糖,血糖控制在正常范围内对减少妊娠期糖尿病产妇分娩巨大儿有指导意义。

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	张硕
	宋薇薇

关键词 ：妊娠期糖尿病, 巨大儿, 相关因素

Abstract：Objective To explore risk factors of macrosomia in women with gestational diabetes.Methods 174 pregnant women with gestational diabetes were divided into two groups: macrosomia group (neonatal birth weight ≥ 4 000 g, n=28 cases) and normal weight group (neonatal birth weight between 2 500 g and 3 999 g, n=146 cases). Additional 19 non-diabetic women who had macrosomia births were used as the control group. Age, preconceptional body mass index, weight gain during pregnancy, fasting blood glucose value, hemoglobin A1c, and glycated albumin were retrospectively analyzed.Results Hemoglobin A1c, preconceptional body mass index, weight gain during pregnancy in diabetic mothers who had macrosomia births were significantly higher than in women who had normal births. In diabetic mothers with normal birth weight neonates, there was a linear positive correlation between hemoglobin A1c and glycated albumin (r=0.3). In diabetic mothers who had macrosomia births, linear positive correlation coefficient between hemoglobin A1c and glycated albumin was also observed (r=0.7). In addition, glycated albumin was positively correlated with neonatal body mass index (r=0.4). The proportion of glucose control in the macrosomia group was lower than that in the normal group.Conclusion Multiple factors were associated with the likelihood of macrosomia in gestational diabetic mothers. In order to prevent perinatal complications, counseling and monitoring during pregnancy were especially important for pregnant women with preconceptional overweight or excessive weight gain during pregnancy.

Key words： Gestational diabetes Macrosomia Risk factor

基金资助:辽宁省教育厅科学技术研究项目(重点实验室项目,LS2010164)

通讯作者: 宋薇薇(songww@sj-hospital.org)

引用本文:

张硕, 宋薇薇. 妊娠期糖尿病产妇分娩巨大儿相关因素分析[J]. 中国生育健康杂志, 2016, 27(3): 215-218.
ZHANG Shuo, SONG Weiwei. Risk factors of macrosomia in women with gestational diabetes. Chinese Journal of Reproductive Health, 2016, 27(3): 215-218.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2016/V27/I3/215

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