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妊娠期糖尿病女性胎儿生长与不同母体代谢特征之间的关联

Association between foetal growth and different maternal metabolic characteristics in women with gestational diabetes mellitus.

作者信息

Krstevska B, Velkoska Nakova V, Adamova G, Simeonova S, Dimitrovski Ch, Livrinova V, Serafimoski V

机构信息

Endocrinology, Diabetes and Metabolic Disorders Clinic, Medical Faculty, Skopje, R. Macedonia.

出版信息

Prilozi. 2009 Dec;30(2):103-14.

Abstract

OBJECTIVE

The aim of the study was to investigate the association between foetal growth and different maternal metabolic characteristics in women with gestational diabetes mellitus (GDM).

METHODS

The study group included 200 consecutive pregnant women who attended the Endocrinology, Diabetes and Metabolic Disorders Outpatient Department in the period from 02.2006 to 02.2009 with singleton pregnancy and GDM diagnosed following ADA criteria. The following parameters were studied: pre-pregnancy maternal body mass index (BMI), 3-hours 100g oral glucose tolerance test (OGTT) results, glycosylated haemoglobin (HbA1c), total lipids (TL), total cholesterol (TH), triglycerides (TG), HDL- and LDL-cholesterol levels at admission. Neonatal birth weight and the prevalence of being large for gestational age (LGA) was an end-point.

RESULTS

We found a significant association between birth weight and pre-pregnancy BMI, HDL-C and birth weight of a large child born previously. Birth weight of a large child born previously was the strongest independent predictor for LGA. The prevalence of LGA (from 27% to 80%) was related to a number of altered maternal characteristics.

CONCLUSION

Pre-pregnancy BMI, HDL-C and birth weight of a large child born previously are the independent predictors for LGA, but results of glucose levels during OGTT are not useful in the prediction of LGA in GDM pregnancies. Probably more factors and other maternal metabolic parameters than glucose levels during OGTT are responsible for the risk of LGA.

摘要

目的

本研究旨在探讨妊娠期糖尿病(GDM)女性胎儿生长与不同母体代谢特征之间的关联。

方法

研究组包括200例连续的孕妇,她们于2006年2月至2009年2月期间前往内分泌、糖尿病和代谢紊乱门诊就诊,均为单胎妊娠且根据ADA标准诊断为GDM。研究了以下参数:孕前母体体重指数(BMI)、3小时100克口服葡萄糖耐量试验(OGTT)结果、糖化血红蛋白(HbA1c)、总脂质(TL)、总胆固醇(TH)、甘油三酯(TG)、入院时高密度脂蛋白和低密度脂蛋白胆固醇水平。新生儿出生体重及大于胎龄儿(LGA)的发生率为终点指标。

结果

我们发现出生体重与孕前BMI、高密度脂蛋白胆固醇(HDL-C)以及既往出生的较大儿童的出生体重之间存在显著关联。既往出生的较大儿童的出生体重是LGA最强的独立预测因素。LGA的发生率(从27%至80%)与多种母体特征改变有关。

结论

孕前BMI、HDL-C以及既往出生的较大儿童的出生体重是LGA的独立预测因素,但OGTT期间的血糖水平结果对GDM妊娠中LGA的预测并无帮助。可能除了OGTT期间的血糖水平外,还有更多因素和其他母体代谢参数与LGA风险相关。

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