妊娠期糖代谢异常导致巨大儿发生的危险因素分析

目的:探讨妊娠期糖代谢异常导致巨大儿发生的相关危险因素,为降低巨大儿的出生率提供科学依据。方法:回顾性分析2007年1月至2009年4月上海市第六人民医院产科收治的妊娠期糖尿病(GDM)孕妇125例和妊娠期糖耐量减低(GIGT)孕妇21例的临床资料。根据是否分娩巨大儿分为两组,采用t检验、卡方检验和多因素Logistic回归分析巨大儿发生的相关危险因素。结果:①单因素分析提示:与非巨大儿组孕妇相比,巨大儿组孕妇的糖尿病家族史、曾分娩巨大儿史、孕前体重、孕期体重增加、空腹血糖水平、OGTT-1小时血糖水平等因素分布差异有统计学意义(P<0.05)。②Logistic多因素回归分析提示:空腹血糖水平升高、孕期体重增加、糖尿病家族史、分娩巨大儿史是巨大儿发生的主要危险因素。③空腹血糖≥5.3mmol/L的孕妇,随着血糖水平的升高,发生巨大儿的风险亦明显增加。结论:对妊娠期糖代谢异常孕妇,应加强其孕期体重和空腹血糖水平的监护和管理,以减少巨大儿的发生及改善相关不良妊娠结局。

Analysis of Risk Factors for Macrosomia in Pregnant Women with Abnormal Glucose Metabolism

Objective:To investigate the risk factors of macrosomia in prgnant women with abnormal glucose metabolism,and to provide the scientific evidence for reducing the birth rate of macrosomia.Methods:The clinical data of 125 patients with GDM and 21 patients with GIGT who were admitted into Shanghai the Sixth People’s Hospital from January,2007 to April,2009 were retrospectively reviewed,all the patients were divided into two groups according to delivery of macrosomia or not.t-test,chi-square test and Logistic regression were used for statistical analysis.Results:①Univariate analysis showed there were significant differences in DM family history,macrosomia history,weight before pregnancy,weight gain during pregnancy,fasting plasma glucose and one hour plasma glucose in OGTT between the two groups(P<0.05).②Logistic regression analysis showed that weight gain during pregnancy,fasting plasma glucose,macrosomia history,and DM family history were main risk factors of macrosomia.③Patients whose fasting glucose ≥5.3 mmol/L had a higher risk for macrosomia with the increase of plasma glucose level.Conclusions:For pregnant women with abnormal glucose metabolism,weigh gain during pregnancy and fasting plasma glucose should be carefully monitored and controlled to reduce the occurrence of macrosomia and related adverse pregnant outcomes.