论文部分内容阅读
目的:研究妊娠合并糖代谢异常孕妇新生儿出生体质量的影响因素。方法:选取妊娠合并糖代谢异常孕妇900例,根据孕前身体质量指数(BMI)分为4组。A组41例为低体重组(BMI<18.5 kg/m2);B组503例为正常体重组(18.5 kg/m2≤BMI≤23.9 kg/m2);C组251例为体重偏高组(24.0 kg/m2≤BMI≤27.9 kg/m2);D组105例为肥胖组(BMI≥2 kg/m2)。900例新生儿按出生体重分为:正常体重新生儿(体重2.5~4.0 kg),适宜体重新生儿(体重3.0~3.5 kg),巨大儿(体重≥4.0 kg)和低体重新生儿(体重≤2.5 kg)。记录孕妇孕前BMI,糖代谢异常诊断时间,血脂水平,新生儿体重等相关指标,计算孕前不同BMI孕妇分娩正常体重新生儿和巨大儿的孕期体重增长,分析影响新生儿出生体重的因素。结果:新生儿平均出生体重:新生儿出生体重随孕前BMI增加而增加,A组新生儿平均出生体重低于其他3组,分别比较,差异均有统计学意义(P均<0.05);但B组、C组、D组间分别比较,差异均无统计学意义(P均>0.05)。在孕妇孕期体重增长的比较中,B、C、D组分娩正常体重儿的孕妇明显低于同组分娩巨大儿的孕妇(P均<0.05)。在孕妇诊断出糖代谢异常孕周的比较中,B、C、组分娩正常体重儿的孕妇明显早于同组分娩巨大儿的孕妇(P均<0.05),D组无统计学差异(P>0.05)。血脂水平的比较中,分娩巨大儿孕妇TG水平高于分娩正常体重儿孕妇(P<0.05);分娩巨大儿孕妇HDL-C水平低于分娩正常体重儿孕妇(P<0.05)。分娩正常体重儿和分娩巨大儿的孕妇相比,有不良产史和糖尿病家族史的例数比较均无统计学差异(P均>0.05)。对多因素进行Logistic回归分析发现,孕前BMI(偏回归系数=0.571、P=0.000、OR=1.772)、孕期体重增长(偏回归系数=0.115、P=0.000、OR=1.124)及HDL-C水平(偏回归系数=-1.758、P=0.000、OR=0.176)为影响新生儿出生体重的危险因素。结论:妊娠合并糖代谢异常孕妇新生儿出生体重与孕前BMI、孕期体质量增长、孕期血浆高密度脂蛋白胆固醇水平相关。
Objective: To study the influencing factors of newborn birth weight in pregnant women with abnormal glucose metabolism. Methods: Nine hundred pregnant women with abnormal glucose metabolism during pregnancy were selected and divided into four groups according to the body mass index (BMI) before pregnancy. A group of 41 patients with low body weight (BMI <18.5 kg / m2); 503 patients in group B were normal weight group (18.5 kg / m2≤BMI≤23.9 kg / m2); 251 patients in group C were high body weight group kg / m2≤BMI≤27.9 kg / m2); Group D 105 cases were obese (BMI≥2 kg / m2). The 900 newborn babies were divided according to their birth weight: normal weight neonates (2.5-4.0 kg body weight), appropriate weight newborns (3.0-3.5 kg body weight), giant children (≥4.0 kg body weight) and low birth weight infants 2.5 kg). BMI of pregnant women before pregnancy, diagnosis of abnormal glucose metabolism time, blood lipid levels, newborn weight and other related indicators were calculated before pregnancy BMI pregnant women with different birth weight and gestational weight of newborns and pregnant children weight growth analysis of factors affecting the birth weight of newborns. Results: The average birth weight of newborns: the birth weight of newborns increased with the increase of BMI before pregnancy, the average birth weight of newborns in group A was lower than the other three groups, the difference was statistically significant (P <0.05) There was no significant difference between group C, group D and group D (all P> 0.05). Pregnant women in the comparison of weight gain during pregnancy, B, C, D group of pregnant women with normal birth weight was significantly lower than the same group of pregnant women with childbirth (P all <0.05). Pregnant women diagnosed with abnormal glucose metabolism compared gestational age, B, C, the composition of pregnant women with normal birth weight was significantly earlier than the same group of pregnant women giving birth to giant children (P all <0.05), D group no significant difference (P> 0.05). In comparison of blood lipid levels, TG levels of pregnant women with childbirth were higher than those with normal birth weight (P <0.05). HDL-C levels of pregnant women with childbirth were lower than those with normal birth weight (P <0.05). There was no significant difference in the number of cases with adverse delivery history and family history of diabetes when compared with pregnant women with childbearing gonads of normal birth weight (P> 0.05). Logistic regression analysis of multiple factors showed that pre-pregnancy BMI (partial regression coefficient = 0.571, P = 0.000, OR = 1.772), pregnancy weight gain (partial regression coefficient = 0.115, P = 0.000, OR = 1.124) and HDL-C (Partial regression coefficient = -1.758, P = 0.000, OR = 0.176) as risk factors affecting newborn birth weight. Conclusions: The birth weight of newborns in pregnant women with abnormal glucose metabolism is related to BMI before pregnancy, body mass gain during pregnancy and plasma HDL cholesterol level during pregnancy.