胎儿体重≥4000克的巨大儿。比较糖尿病和非糖尿病孕妇的母婴结局。

Fetal macrosomia greater than or equal to 4000 grams. Comparing maternal and neonatal outcomes in diabetic and nondiabetic women.

作者信息

Saleh Ahmed, Al-Sultan Sultan M, Moria Anwar M, Rakaf Fatema I, Turkistani Yasmin M, Al-Onazi Shaha H H

机构信息

Department of Obstetrics and Gynecology, Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia.

出版信息

Saudi Med J. 2008 Oct;29(10):1463-9.

PMID:18946574

Abstract

OBJECTIVE

To compare maternal and neonatal outcomes of fetal macrosomia in diabetic and nondiabetic women.

METHODS

A retrospective case-control study was conducted at Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia from January 2004 to December 2006. A total of 766 macrosomic newborns met the inclusion criteria. We compared maternal and neonatal characteristics and outcomes between diabetic (group 1, n=207) and nondiabetic (group 2, n=559) women.

RESULTS

There were significantly more macrosomic newborns in nondiabetic women; 73% versus 27% in diabetic women, p=0.0001. Cesarean deliveries were significantly higher in diabetic women compared to nondiabetic women (30.4% versus 19.5%, p=0.002). There were no significant differences between either group in total maternal morbidity (12.6% versus 14.1%, p=0.7). There were significantly more severe cases of shoulder dystocia occurring in newborns of diabetic women compared to nondiabetic women (1.9% versus 0.2%, p=0.03).

CONCLUSION

Elective cesarean delivery for estimated fetal weight > or =4500g for nondiabetic women and > or =4250 g for diabetic women may avoid severe shoulder dystocia without increasing maternal morbidity rates.

摘要

目的

比较糖尿病和非糖尿病孕妇巨大儿的母婴结局。

方法

2004年1月至2006年12月在沙特阿拉伯王国利雅得市利雅得军事医院进行一项回顾性病例对照研究。共有766例巨大儿新生儿符合纳入标准。我们比较了糖尿病组（第1组，n = 207）和非糖尿病组（第2组，n = 559）孕妇的母婴特征及结局。

结果

非糖尿病孕妇的巨大儿新生儿显著更多；非糖尿病孕妇中占73%，糖尿病孕妇中占27%，p = 0.0001。糖尿病孕妇的剖宫产率显著高于非糖尿病孕妇（30.4%对19.5%，p = 0.002）。两组的孕产妇总发病率无显著差异（12.6%对14.1%，p = 0.7）。与非糖尿病孕妇相比，糖尿病孕妇新生儿发生严重肩难产的病例显著更多（1.9%对0.2%，p = 0.03）。