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母亲低血糖与低出生体重和低胎盘重量的关联:一项回顾性调查。

Association of maternal hypoglycemia with low birth weight and low placental weight: a retrospective investigation.

作者信息

Vadakekut Elsa S, McCoy Sarah J Breese, Payton Mark E

机构信息

Women's Health Care, Oklahoma City, OK, USA.

出版信息

J Am Osteopath Assoc. 2011 Mar;111(3):148-52.

Abstract

CONTEXT

The effects of maternal hypoglycemia on birth weight, placental weight, and placental ratio are unclear. A reliable indicator for increased risk of low birth weight or associated low placental weight could prove invaluable in caring for newborns who are small for gestational age.

OBJECTIVE

To retrospectively review 2 years of hospital obstetric records for evidence of an association between maternal hypoglycemia (< fifth percentile at 24-week 1-hour glucose challenge test) and birth weight, placental weight, or placental ratio.

METHODS

Medical center records were reviewed for women who delivered a term newborn between July 1, 2005, and July 31, 2007. Women included in the study were younger than 35 years and had completed a 1-hour glucose challenge test during pregnancy. Excluded were women with comorbid conditions that may be associated with abnormal birth weight and women with serum glucose levels greater than 135 mg/dL.

RESULTS

Newborns of women with hypoglycemia weighed, on average, significantly less than newborns of women with normal blood glucose levels (t test P=.011). Relative risk was 5.81 (95% confidence interval, 1.25-27.03). Placentas of women with hypoglycemia were also lighter than those of the women in the control group, but the difference was not significant (t test P=.1089). Differences in placental ratios between the 2 groups were not statistically significant (P=.8171).

CONCLUSION

Lower serum glucose levels during pregnancy might be a causative factor, rather than merely a risk factor, for lower birth weights.

摘要

背景

母亲低血糖对出生体重、胎盘重量和胎盘比率的影响尚不清楚。对于评估小于胎龄儿出生体重偏低风险增加或伴有胎盘重量偏低而言,一个可靠的指标在照顾此类新生儿时可能具有极高的价值。

目的

回顾性分析两年的医院产科记录,以寻找母亲低血糖(24周1小时葡萄糖耐量试验中处于第五百分位数以下)与出生体重、胎盘重量或胎盘比率之间存在关联的证据。

方法

对2005年7月1日至2007年7月31日期间分娩足月新生儿的女性的医疗中心记录进行审查。纳入研究的女性年龄小于35岁,且在孕期完成了1小时葡萄糖耐量试验。排除可能与出生体重异常相关的合并症女性以及血糖水平高于135mg/dL的女性。

结果

低血糖女性所生新生儿的平均体重显著低于血糖正常女性所生新生儿(t检验P = 0.011)。相对风险为5.81(95%置信区间,1.25 - 27.03)。低血糖女性的胎盘也比对照组女性的胎盘轻,但差异不显著(t检验P = 0.1089)。两组之间胎盘比率的差异无统计学意义(P = 0.8171)。

结论

孕期较低的血糖水平可能是出生体重较低的一个致病因素,而非仅仅是一个风险因素。

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