孕妇体质量和血糖情况对分娩巨大儿的影响研究

发布时间：2018-07-13 14:19

【摘要】：目的探讨孕期体质量变化和血糖情况对分娩巨大儿的影响。方法选取2012年6月1日—2013年6月1日在常州市妇幼保健院分娩的450例孕妇资料进行回顾性分析,分为两组。其中巨大儿组包括非妊娠期糖尿病(GDM)巨大儿150例、GDM巨大儿60例,正常体质量儿组包括无妊娠期并发症出生正常体质量儿150例、合并GDM但出生正常体质量儿90例。记录两组孕妇孕前体质量、孕期的体质量变化及血糖情况,进行比较分析。结果 (1)无论是在GDM还是非GDM孕妇中,巨大儿组孕前体质量、孕前BMI、孕期增重均高于正常体质量儿组,差异有统计学意义(P0.05)。无论是在一项血糖异常还是多项血糖异常的GDM孕妇中,巨大儿组孕前体质量、孕前BMI均高于正常体质量儿组,差异有统计学意义(P0.05)。(2)多项血糖异常组孕妇分娩巨大儿的发生率(50.9%,30/59)高于一项血糖异常组(33.0%,30/91),差异有统计学意义(χ2=4.768,P=0.029)。在GDM孕妇中,巨大儿组餐后1 h血糖值〔(10.5±1.3)mmol/L〕高于正常体质量儿组〔(10.0±1.5)mmol/L〕,差异有统计学意义(t=-2.234,P=0.027)。(3)Logistic回归分析显示,孕前体质量〔OR=1.097,95%CI(1.064,1.131)〕、孕期增重〔OR=1.145,95%CI(1.088,1.205)〕、孕周〔OR=1.973,95%CI(1.508,2.582)〕是巨大儿发生的危险因素(P0.05)。结论巨大儿的发生与孕妇体质量和血糖情况均有关,但孕期体质量对巨大儿发生的影响更大,对孕期体质量过高、多项血糖异常以及75 g葡萄糖耐量试验(OGTT)检测结果中餐后血糖1 h值异常的孕妇要加强管理。
[Abstract]:Objective to investigate the effect of body mass change and blood sugar on macrosomia during pregnancy. Methods 450 pregnant women who were delivered in Changzhou Maternal and Child Health Hospital from June 1, 2012 to June 1, 2013 were retrospectively analyzed and divided into two groups. Among them, the macrosomia group consisted of 150 cases of macrosomia without gestational diabetes mellitus (GDM), 60 cases of GDM macrosomia, 150 cases of normal birth weight without complications of pregnancy, and 90 cases of normal birth weight infants with GDM. The body weight, body mass and blood sugar of the two groups were recorded and analyzed. Results (1) in both GDM and non-GDM pregnant women, the weight before pregnancy, BMIand weight gain during pregnancy in macrosomia group were significantly higher than those in normal group (P0.05). Whether in GDM pregnant women with one or more abnormal blood glucose, the pregestational weight and BMI of macrosomia group were higher than those of normal body mass group. The difference was statistically significant (P0.05). (2). The incidence of macrosomia in multiple abnormal blood glucose groups (50.9%) was higher than that in one item group (33.0% / 91), and the difference was statistically significant (蠂 2 + 4.768% P 0.029). 1 h postprandial blood glucose level (10.5 卤1.3) mmol / L) in macrosomia group was significantly higher than that in normal body mass group (10.0 卤1.5) mmol / L), and the difference was statistically significant (tr -2.234 P0. 027). (3) logistic regression analysis showed that the gestational weight (OR 1.097 95 CI (1.064 卤1.131),) pregnancy weight gain (OR 1.14595 CI (1.0885 卤1.205),) was significantly higher than that in normal birth weight group (10.0 卤1.5) mmol / L). Gestational week (ORL 1.973T95 CI (1.508 卤2.582) was the risk factor of macrosomia (P0.05). Conclusion the occurrence of macrosomia is related to the body mass and blood sugar of pregnant women, but the body mass of pregnancy has more influence on the occurrence of macrosomia, and the weight of macrosomia is too high during pregnancy. The results of 75 g glucose tolerance test (OGTT) showed that pregnant women with abnormal blood glucose of 1 h after meal should strengthen their management.
【作者单位】：南京医科大学附属常州妇幼保健院;
【分类号】：R714.4

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