孕中晚期血糖血脂水平与巨大儿发生风险的相关性研究  

Correlation between blood glucose and lipids levels in the middle-late stages of pregnancy and macrosomia

作　　者：孙洪霞 李楠 SUN Hongxia;LI Nan(Department of Obstetrics,Tongzhou Maternity and Child Health Care Hospital,Beijing 101100)

机构地区：[1]北京市通州区妇幼保健院产科,北京101100

出　　处：《国际检验医学杂志》2023年第22期2779-2782,共4页International Journal of Laboratory Medicine

基　　金：北京市通州区科技计划项目(KJ2019CX011)。

摘　　要：目的分析孕妇孕前体质量指数(BMI)、孕中晚期糖化清蛋白(GA)、三酰甘油(TG)等糖脂代谢相关实验室指标与巨大儿发生风险的关系,旨在为预防巨大儿发生提供依据。方法回顾性分析2018年3月至2022年12月于该院进行产检的孕妇1353例,收集孕前BMI、妊娠期糖尿病(GDM)、孕中晚期GA、TG、新生儿出生体质量等临床资料。以孕前BMI进行分组,分别采用Kruskal-Wallis检验和Mann-Whitney检验对多组间及亚组间的GDM、GA、TG和新生儿出生体质量的中位数进行比较,采用Pearson相关性分析对多组间及亚组间的GDM、高GA、高TG和巨大儿的发生率进行比较,采用Logistics回归分析孕前BMI、GDM、孕中晚期高GA、高TG血症与巨大儿发生的相关性。结果孕前肥胖组的孕中晚期GA水平及新生儿出生体质量均显著高于其他3组,肥胖组和超重组的TG水平显著高于正常组和消瘦组。随着BMI的增加,巨大儿、GDM、高GA水平、高TG血症的发生率均呈递增变化,组间比较差异有统计学意义(P<0.01)。Logistic回归发现,孕前超重肥胖和孕中晚期高GA水平是巨大儿发生的独立危险因素。结论孕前超重肥胖和孕中晚期高GA水平显著增加了巨大儿的发生风险。重视孕前体质量管理及加强孕期GA水平监管有助于降低巨大儿发生。Objective To analyze the relationship between pre-pregnancy body mass index(BMI),glycated albumin(GA),triglycerides(TG),and other glucose and lipid metabolism related indicators of pregnant women with the risk of macrosomia,in order to provide a basis for preventing macrosomia.Methods A retrospective analysis was conducted on 1353 pregnant women who underwent prenatal examination in the hospital from March 2018 to December 2022.Clinical data such as pre-pregnancy BMI,gestational diabetes(GDM),GA and TG in the middle-late pregnancy,and neonatal birth weight were collected.The pregnant women were grouped based on pre-pregnancy BMI,Kruskal-Wallis test and Mann Whitney test were used to compare the median GDM,GA,TG,and neonatal birth weight among multiple groups and subgroups,respectively.Pearson correlation analysis was used to compare the incidence rates of GDM,high GA,high TG,and macrosomia between multiple groups and between two groups.Logistic regression analysis was used to investigate the correlation between pre-pregnancy BMI,GDM,high GA,high TG in middle-late pregnancy and the occurrence of macrosomia.Results The GA levels in the middle-late pregnancy and neonatal birth weight in the obesity group were significantly higher than those in the other three groups,while the levels of TG and neonatal birth weight in the obese group and overweight group were significantly higher than those in the normal group and lean group.With the increase of BMI,the incidence rate of macrosomia,GDM,high GA level,and hypertriglyceridemia showed increasing trends,with significant differences between groups(P<0.01).Logistic regression analysis results showed that overweight and obesity before pregnancy and high GA level in the middle-late pregnancy were independent risk factors for the occurrence of macrosomia.Conclusion Pre-pregnancy overweight and obesity,and high GA levels in the middle-late stages of pregnancy significantly increase the risk of macrosomia.Emphasizing weight management before pregnancy and strengthening monitorin

关 键 词：孕前超重肥胖 妊娠期糖尿病 糖化清蛋白 三酰甘油 巨大儿 

分 类 号：R714.256[医药卫生—妇产科学]