妊娠期糖尿病患者HbA1c表达与BMI、新生儿体重及妊娠结局的相关性  

Correlation between HbA1c level of pregnant women with gestational diabetes mellitus and maternal BMI, neonatal weight, and pregnancy outcomes

作　　者：徐梅佳[1] 薛春燕 路黎娟[1] XU Meijia;XUE Chunyan;LU Lijuan(Shanghai Ninth People’s Hospital affiliated to Shanghai Jiaotong University School of medicine,Shanghai,201900)

机构地区：[1]上海交通大学医学院附属第九人民医院,201900

出　　处：《中国计划生育学杂志》2022年第8期1766-1770,1775,共6页Chinese Journal of Family Planning

摘　　要：目的:分析妊娠期糖尿病(GDM)孕妇妊娠晚期糖化血红蛋白(HbA1c)水平与分娩前体质指数(BMI)、新生儿体重和不良妊娠结局的相关性。方法:回顾性收集2019年1月-2020年1月在本院建卡并分娩的单胎GDM孕妇及其新生儿相关资料,根据妊娠晚期HbA1c水平分为A组64例,HbA1c<5.5%;B组32例,HbA1c 5.5%~6%;C组69例,HbA1c≥6%。比较各组孕妇一般资料、分娩前BMI、新生儿体重、Apgar评分、新生儿感染、剖宫产率等不良妊娠结局。结果:各组GDM孕妇年龄、产次、糖尿病家族史、不良孕产史没有差别(P>0.05)。B组和C组分娩前BMI高于A组(P<0.001);孕晚期HbA1c与分娩前BMI呈正相关(r=0.647,P<0.001),与新生儿体重呈弱正相关(r=0.2952,P<0.001);C组巨大儿出生率(30.4%)高于A组(4.7%)和B组(6.3%),B组和C组新生儿1min Apgar评分(8.1±0.9分、8.0±1.0分)低于A组(8.6±0.9分),C组新生儿感染率(20.3%)、剖宫产率(36.2%)均高于A组(7.8%、20.3%)和B组(12.5%、21.9%)(均P<0.05)。羊水污染率、早产率、宫内窘迫率、胎膜早破率3组未见差异(P>0.05)。结论:GDM孕妇妊娠晚期HbA1c水平与分娩前BMI和新生儿体重呈正相关,GDM孕妇血糖控制不佳时(HbA1c≥6%)巨大儿出生率和剖宫产率均显著上升。Objective: To analyze the correlation between glycosylated hemoglobin(HbA1 c) level of pregnant women with gestational diabetes mellitus(GDM) during the third trimester of pregnancy and their body mass index(BMI) before delivery, neonatal weight, and their adverse pregnancy outcomes. Methods: The related data of pregnant women with GDM who established cards and gave birth and their newborns were collected retrospectively. According to the average level of HbA1 c during the third trimester of pregnancy, these women were divided into three groups, including 64 cases with HbA1 c<5.5% in group A, 32 cases with 5.5%≤HbA1 c<6.0% in group B, and 69 cases with HbA1 c≥6.0% in group C. The general information, BMI before delivery, neonatal weight, Apgar score, neonatal infection rate, cesarean section rate, and other adverse pregnancy outcomes were compared among the three groups. Results: There was no significant difference in age, parity, family history of diabetes, and history of adverse pregnancy of the women among the three groups(P>0.05). The pre-delivery BMI value of the women in group B and group C was significantly higher than that of the women in group A(P<0.001).There was a significant positive correlation between the average HbA1 c level of the women during the third trimester of pregnancy and their pre-delivery BMI(r=0.647, P<0.001). Meanwhile, the average HbA1 c of the women during the third trimester of pregnancy had a weak positive correlation with their neonatal weight(r=0.2952, P<0.001). The birth rate of macrosomia in group C(30.4%) was significantly higher than that(4.7%) in group A, and that(6.3%) in group B(P<0.05). The 1 min Apgar score of newborns in group B and C(8.1±0.9and 8.0±1.0)was significantly lower than that(8.6±0.9in group A(P<0.05).The neonatal infection rate(20.3%)and the cesarean section rate(36.2%)in group C were significantly higher than those(7.8% and 20.3%)in group A,and those(12.5% and 21.9%)in group B(all P<0.05).There were no significant differences in the rates of amniotic

关 键 词：妊娠期糖尿病 糖化血红蛋白 体质指数 新生儿体重 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]