糖代谢异常孕妇体质量及相关因素对新生儿出生体质量的影响  

Factors relevant to newborn birth weight in pregnancy complicated with abnormal glucose Metabolism

作　　者：杨延冬[1] 翟桂荣[2] 杨慧霞[2] 

机构地区：[1]滨州医学院附属医院妇产科,256603 [2]北京大学第一医院妇产科,100034

出　　处：《中华妇产科杂志》2010年第9期646-651,共6页Chinese Journal of Obstetrics and Gynecology

基　　金：基金项目：国家自然科学基金（30973212）;“985工程”二期建设项目（985-2-015-24）

摘　　要：目的 探讨影响糖代谢异常孕妇新生儿出生体质量的相关因素.方法 选择2005年1月-2009年12月在北京大学第一医院分娩的临床资料齐全的妊娠合并糖代谢异常足月单胎孕妇1157例,根据孕前体质指数（BMI）分成4组：53例BMI＜18.5 kg/m2为低体质量组,647例BMI18.5～23.9 kg/m2为理想体质量组,323例BMI 24.0～27.9 kg/m2为超体质量组,134例BMI≥28.0 kg/m2为肥胖组.1157例新生儿按出生体质量分为：出生体质量2500～4000 g为正常体质量儿（987例）,其中545例出生体质量3000～3500 g为适宜体质量儿;出生体质量≥4000 g为巨大儿（112例）;出生体质量＜2500 g为低体质量儿（58例）.记录其孕前体质量、身高、糖代谢异常诊断时间及诊断时体质量、孕期血脂水平、不良产史、糖尿病家族史、分娩孕周、分娩时体质量、新生儿出生体质量.分析孕前BMI、孕期体质量增长（分娩时体质量-孕前体质量）、诊断糖代谢异常的孕周、诊断后孕妇体质量增长（分娩时体质量-诊断糖代谢异常时体质量）、孕期血脂水平、不良产史及糖尿病家族史对新生儿出生体质量的影响及计算孕前不同BMI孕妇分娩适宜体质量儿的孕期体质量适宜增长范围.结果 （1）新生儿平均出生体质量：低体质量组为（3142±333）g,理想体质量组为（3339±476）g,超体质量组为（3381±581）g,肥胖组为（3368±644）g.新生儿出生体质量随孕前BMI增加而增加,低体质量组新生儿平均出生体质量低于其他3组,分别比较,差异均有统计学意义（P＜0.05）;但理想体质量组、超体质量组、肥胖组间分别比较,差异均无统计学意义（P＞0.05）.（2）分娩正常体质量儿和巨大儿孕妇的孕期体质量增长：分娩正常体质量儿及分娩巨大儿的各组孕妇孕期体质量增长为,理想体质量组分别为（13.5±4.5）及（17.1±5.4）kg,超体质量组分别为（11.6±4.9）及（15.3±6.4）kg,�Objective To investigate the influencing factors of neonatal birth body mass in women with abnormal glucose metabolism during pregnancy. Methods A study was conducted on 1157 singleton gravidas, who were diagnosed and treated for abnormal glucose metabolism and delivered in the Department of Obstetrics and Gynecology, First Hospital, Peking University from January 2005 to December 2009, by reviewing the medical records. Based on the pre-pregnant body mass index, the selected cases were divided into 4 groups： low body mass group [ body mass index （BMI） 〈 18.5 kg/m2, n =53], ideal body mass group （ BMI 18.5 - 23.9 kg/m2, n = 647 ）, over body mass group （ BMI 24.0 - 27.9 kg/m2, n = 323 ）,and obese group （BMI≥28.0 kg/m2, n = 134）. 1157 newborns were divided by birth body mass into 3 groups： normal birth body mass group （body mass 2500 -4000 g, n =987）, of which 545 cases of birth body mass 3000 -3500 g for the appropriate newborns, macrosomia group （body mass≥4000 g, n = 112）;low birth body mass group （body mass 〈 2500 g, n = 58 ）. The following information was collected,including pre-pregnancy body mass, height, gestational age of diagnosis and body mass gain after diagnosis,maternal serum level of cholesterol, history of adverse pregnancy, and family history of diabetes, gestational age, delivering body mass, neonatal birth body mass. The influence of pre-pregnant BMI, body mass gain during pregnancy, gestational age of diagnosis, body mass gain after diagnosis, maternal serum level of cholesterol, family history of diabetes on the newborns＇ birth body mass was analyzed. The appropriate ranges of gestational body mass gain were calculated in women with abnormal glucose metabolism. Results （ 1 ）The average neonatal birth body mass for each group respectively were （3142 ±333） g for low body mass group, （3339 ±476） g for the ideal body mass group, （3381 ±581） g for over body mass group, and （3368 ± 644） g for obese group. The neonatal birth body mass wa

关 键 词：葡萄糖代谢障碍 糖尿病 妊娠 体重增长 出生体重 人体质量指数 

分 类 号：R686[医药卫生—骨科学]