| 黄三唤,徐叶清,陈茂林,黄锟,潘维君,葛星,严双琴,毛雷婧,牛影童,世庐,陶芳标.孕中期血糖水平与新生儿出生体重的队列研究[J].Chinese journal of Epidemiology,2016,37(1):45-49 |
| 孕中期血糖水平与新生儿出生体重的队列研究 |
| Mid-gestational glucose levels and newborn birth weight: birth cohort study |
| Received:May 25, 2015 |
| DOI：10.3760/cma.j.issn.0254-6450.2016.01.009 |
| KeyWord: 孕期血糖 出生体重 大于胎龄儿 小于胎龄儿 |
| English Key Word: Maternal glucose Birth weight Large for gestational age Small for gestational age |
| FundProject:国家自然科学基金(81330068,81373012);马鞍山市卫生局科教专项资金 |
| Author Name | Affiliation | E-mail | | Huang Sanhuan | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Provincial Laboratory for Population Health and Eugenics, Hefei 230032, China | | | Xu Yeqing | Department of Administration, Maternal and Child Health Care Center of Ma'anshan, Ma'anshan 243000, China | | | Chen Maolin | Department of Obstetrics and Gynecology, Maternal and Child Health Care Center of Ma'anshan, Ma'anshan 243000, China | | | Huang Kun | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Provincial Laboratory for Population Health and Eugenics, Hefei 230032, China | | | Pan Weijun | Department of Obstetrics and Gynecology, Maternal and Child Health Care Center of Ma'anshan, Ma'anshan 243000, China | | | Ge Xing | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Provincial Laboratory for Population Health and Eugenics, Hefei 230032, China | | | Yan Shuangqin | Department of Health Care, Maternal and Child Health Care Center of Ma'anshan, Ma'anshan 243000, China | | | Mao Leijing | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Provincial Laboratory for Population Health and Eugenics, Hefei 230032, China | | | Niu Ying | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Provincial Laboratory for Population Health and Eugenics, Hefei 230032, China | | | Tong Shilu | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Provincial Laboratory for Population Health and Eugenics, Hefei 230032, China | s.tong@qut.edu.au | | Tao Fangbiao | Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui Provincial Laboratory for Population Health and Eugenics, Hefei 230032, China | |
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| Abstract: |
| 目的 探讨孕中期孕妇75 g口服糖耐量试验(OGTT)的3项血糖值与出生体重的关系。方法 参与前瞻性队列研究的3 081名孕妇于孕≤14周时收集基础人口统计学信息,在孕24～28周行75 g OGTT,利用多项logistic回归法分析新生儿出生体重的影响因素及孕中期FPG和OGTT-1 h、OGTT-2 h值四分位分组的大于胎龄儿(LGA)发生风险,以多元线性回归法分析血糖值与新生儿出生体重的关系。结果 孕前超重(24.0 kg/m2≤BMI <28.0 kg/m2)(OR=1.4,95%CI:1.0～2.0,P=0.029)、妊娠期糖尿病(OR=2.4,95%CI:1.8～3.2,P <0.001)是LGA发生的危险因素;孕前消瘦(BMI <18.5 kg/m2)(OR=1.6,95%CI:1.2～2.2,P=0.003)、子痫前期(OR=4.0,95%CI:1.9～8.4,P <0.001)可增加小于胎龄儿出生的风险。多元线性回归分析调整孕前BMI、产次、高血压情况、新生儿性别后,FPG、OGTT-1 h和OGTT-2 h均与新生儿出生体重呈正相关关系(β 值分别为91.99、33.60、32.00,P值均 <0.001)。随着孕妇3项血糖水平四分位升高各组出生体重呈增大趋势,且LGA发生风险逐渐增大。结论 孕中期血糖水平与子代出生体重呈正相关。随着血糖水平升高,新生儿出生体重增大,LGA发生风险升高,但小于胎龄儿与血糖无关联。FPG值对发生LGA有很好的预测作用。 |
| English Abstract: |
| Objective To understand the association between the blood glucose levels of pregnant women in second trimester detected by 75 gram oral glucose tolerance test (OGTT) and the birth weight of neonates. Methods Demographic information collection and OGTT were conducted for 3 081 pregnant women at ≤14 gestational weeks and 24-28 gestational weeks respectively. Multiple logistic regression analysis was done to identify the factors associated with the birth weight and the risks of large for gestational age (LGA) in three levels (FPG, OGTT-1 h and OGTT-2 h) of OGTT percentile group, multiple linear regression analysis was used to evaluate the relationships between maternal glucose levels and neonate birth weight. Results Pre-pregnancy obesity (24.0 kg/m2≤ BMI <28.0 kg/m2) (OR=1.4, 95%CI:1.0-2.0, P=0.029) and gestational diabetes mellitus (OR=2.4, 95%CI: 1.8-3.2, P <0.001) were the risk factors. Pre-pregnancy underweight (BMI <18.5 kg/m2) (OR=1.6, 95%CI: 1.2-2.2, P=0.003), preeclampsia (OR=4.0, 95%CI: 1.9-8.4, P <0.001) increased the risk for small for gestational age (SGA). Multiple linear regression analysis showed neonate birth weight was positive correlated with maternal glucose levels (β were 91.99, 33.60, 32.00, respectively, P <0.001). Percentile groups of each OGTT level was linearly positive associated with increased mean value of neonate birth weight, and so with the risk of LGA. Conclusions There were positive correlations between maternal glucose levels and neonate birth weight. The risk of LGA increased with the maternal glucose levels, but there was no statistical association between SGA and maternal glucose levels. FPG level is one of the predictors of LGA. Active surveillance and control of maternal glucose level can effectively reduce the risk of LGA. |
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