Fraser D, Weitzman S, Leiberman J R, Eschwege E
Epidemiology and Health Services Evaluation Unit, Soroka Medical Center, Beersheva, Israel.
Eur J Epidemiol. 1990 Dec;6(4):427-31. doi: 10.1007/BF00151720.
Maternal diabetes is known to be related to an increase in birth weight of the offspring. However, the mechanism of the association is not entirely clear. In addition, the contribution of the demographic, obstetric and metabolic factors to birth weight in diabetic mothers is not well defined. All the diabetic women (68 requiring insulin-treatment and 403 on diet alone) and a random sample of 1 in 12 of all non-diabetic women (893 women) who delivered in one regional hospital between March 1987 and June 1988 inclusive, were included in the study. Tests for gestational diabetes are routinely performed in our pregnant women population, thus, the study is a population based one. The mean birth weight of infants of diabetic mothers adjusted for gestational age was higher than in those of non-diabetic mothers. However, no relationship was found between maternal glycosylated hemoglobin measured at delivery and the infants birth weight. Furthermore, at each week of gestation, infants born to diabetic mothers were heavier than the infants of non-diabetic mothers (for weeks 37 to 40, p less than 0.05), while no differences were found in glycosylated hemoglobin levels between the two groups at any time. In a multivariate model we showed that after controlling for gestational age, the only factors which independently and significantly affected birth weight in our population were diabetes, ethnic origin, and the parity of the mother. Our findings support the possibility that substances which induce hyperinsulinemia, other than glucose, may be related to the higher birth weight of infants of diabetic mothers.
众所周知，母体糖尿病与后代出生体重增加有关。然而，这种关联的机制尚不完全清楚。此外，人口统计学、产科和代谢因素对糖尿病母亲所生孩子出生体重的影响也未得到明确界定。1987年3月至1988年6月（含）期间在一家地区医院分娩的所有糖尿病女性（68例需要胰岛素治疗，403例仅接受饮食治疗）以及所有非糖尿病女性中每12人随机抽取1人的样本（893名女性）被纳入研究。我们对孕妇群体常规进行妊娠期糖尿病检测，因此，该研究是以人群为基础的。校正胎龄后，糖尿病母亲所生孩子的平均出生体重高于非糖尿病母亲所生孩子。然而，分娩时测得的母体糖化血红蛋白与婴儿出生体重之间未发现相关性。此外，在妊娠的每一周，糖尿病母亲所生婴儿均比非糖尿病母亲所生婴儿重（妊娠37至40周，p<0.05），而两组在任何时候的糖化血红蛋白水平均无差异。在多变量模型中，我们发现，在控制胎龄后，在我们的研究人群中，唯一独立且显著影响出生体重的因素是糖尿病、种族和母亲的产次。我们的研究结果支持这样一种可能性，即除葡萄糖外，诱导高胰岛素血症的物质可能与糖尿病母亲所生婴儿出生体重较高有关。
