Salim Raed, Hasanein Jamal, Nachum Zohar, Shalev Eliezer
Ha'Emek Medical Center, Obstetrics and Gynecology, Afula, Israel.
Obstet Gynecol. 2004 Nov;104(5 Pt 1):1021-4. doi: 10.1097/01.AOG.0000143821.00194.ad.
Differences in weight and body composition have been reported between infants of nondiabetic and diabetic mothers. These differences may explain the propensity for shoulder dystocia in the diabetic population. We investigated whether differences in anthropometric measurements still exist between infants of nondiabetic and diabetic mothers following strict glycemic control.
This was a prospective cohort study. The study group included infants of well-controlled gestational diabetic mothers (mean capillary glucose less than 100 mg/dL). Controls were infants of nondiabetic mothers matched for gender, gestational age, ethnicity, and birth weight. Only singleton term pregnancies were included. Both groups were studied within 24 hours of delivery. The following measurements were obtained: birth weight, infant length, femur length, head, chest, abdomen and thigh circumferences, and biacromial distance. Student t tests were used to compare the measured parameters between groups. P < .05 was considered significant. A sample size of 63 subjects in each group was needed to demonstrate a difference of 0.5 cm (+/- 1.0 cm) of the biacromial distance between the 2 groups, which we considered clinically significant, with a probability of 95% and power of 80%.
Sixty seven infants in each group were included in the study. Anthropometric measurements did not differ significantly between the groups. We did a secondary analysis on neonates who weighed 4,000 g or more at birth. Anthropometric measurements again did not differ significantly between the groups.
Anthropometric measurements of infants of mothers with well-controlled gestational diabetes do not differ from infants of nondiabetic mothers.
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已有报道称,非糖尿病母亲和糖尿病母亲所生婴儿在体重和身体组成方面存在差异。这些差异可能解释了糖尿病患者发生肩难产的倾向。我们调查了在严格血糖控制后,非糖尿病母亲和糖尿病母亲所生婴儿在人体测量学指标上是否仍存在差异。
这是一项前瞻性队列研究。研究组包括血糖控制良好的妊娠期糖尿病母亲所生婴儿(平均毛细血管血糖低于100mg/dL)。对照组为非糖尿病母亲所生婴儿,在性别、胎龄、种族和出生体重方面进行匹配。仅纳入单胎足月妊娠。两组均在分娩后24小时内进行研究。测量以下指标:出生体重、婴儿身长、股骨长度、头围、胸围、腹围和大腿围以及双肩峰间距离。采用学生t检验比较两组间的测量参数。P <.05被认为具有统计学意义。每组需要63名受试者的样本量,以证明两组间双肩峰间距离存在0.5cm(±1.0cm)的差异,我们认为这具有临床意义,概率为95%,检验效能为80%。
每组67名婴儿纳入研究。两组间人体测量学指标无显著差异。我们对出生体重4000g或以上的新生儿进行了二次分析。两组间人体测量学指标再次无显著差异。
血糖控制良好的妊娠期糖尿病母亲所生婴儿的人体测量学指标与非糖尿病母亲所生婴儿无差异。
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