Green J R, Schumacher L B, Pawson I G, Partridge J C, Kretchmer N
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco.
Obstet Gynecol. 1991 Aug;78(2):235-40.
Many physicians believe that macrosomia is a hallmark of a pregnancy complicated by glucose intolerance. Because the prevalence of obesity is increased among women with gestational diabetes, fetal overgrowth may be attributable at least in part to maternal obesity. We studied 2069 black, Latina, Chinese, and white mother-infant pairs to determine the interaction between maternal body habitus, maternal glucose homeostasis, and certain indices of fetal growth. Chinese women had a significantly higher serum glucose 1 hour after administration of 50 g glucose (136.6 +/- 32.7 mg/dL) than any of the other three ethnic groups. Black women had a significantly lower value for glucose (114.8 +/- 28.2 mg/dL) than either Chinese or Latina women (124.9 +/- 31.4 mg/dL). Results for Latina and white women (121.5 +/- 26.2 mg/dL) were not significantly different. Body mass index (BMI) was used to classify the subjects. The regression coefficient for the entire sample indicated a modest association of glucose with increased birth weight when maternal BMI was controlled. The BMI of the Chinese infants had a significant association with higher concentrations of glucose after administration of 50 g glucose. Maternal body habitus should be considered a major confounder in studies of the relationship of maternal glucose tolerance and infant birth weight.
许多医生认为巨大儿是妊娠期糖耐量异常的一个标志。由于妊娠期糖尿病女性中肥胖的患病率增加，胎儿过度生长可能至少部分归因于母亲肥胖。我们研究了2069对黑人、拉丁裔、华裔和白人母婴对，以确定母亲体型、母亲葡萄糖稳态和某些胎儿生长指标之间的相互作用。华裔女性在服用50克葡萄糖1小时后的血清葡萄糖水平（136.6±32.7毫克/分升）显著高于其他三个种族中的任何一个。黑人女性的葡萄糖水平（114.8±28.2毫克/分升）显著低于华裔或拉丁裔女性（124.9±31.4毫克/分升）。拉丁裔和白人女性的结果（121.5±26.2毫克/分升）没有显著差异。使用体重指数（BMI）对受试者进行分类。当控制母亲BMI时，整个样本的回归系数表明葡萄糖与出生体重增加之间存在适度关联。华裔婴儿的BMI与服用50克葡萄糖后更高的葡萄糖浓度存在显著关联。在研究母亲糖耐量与婴儿出生体重的关系时，母亲体型应被视为一个主要的混杂因素。
