Wang L-F, Wang H-J, Ao D, Liu Z, Wang Y, Yang H-X
Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, Beijing, China.
J Perinatol. 2015 Dec;35(12):985-90. doi: 10.1038/jp.2015.119. Epub 2015 Sep 24.
To determine the effects of gestational diabetes mellitus (GDM) and pre-pregnancy obesity on macrosomia and large for gestational age (LGA).
We conducted a prospective cohort study of 587 GDM women and 478 non-GDM women from 2012 to 2013. We collected their data of the pre-pregnancy weight, sociodemographic data, medical histories, clinical treatment, and followed-up the outcomes of delivery including birth weight. Multiple logistic regression models were used to test associations between pre-pregnant obesity and macrosomia/LGA and between GDM and macrosomia/LGA.
Of 1065 women we studied, obese women had 4.17 times and 2.27 times increased risk of developing macrosomia (95% CI: 2.52 to 6.91) and LGA (95% CI: 1.60 to 3.21), respectively, than non-obese women after adjustment for maternal age, gestational weeks and GDM. We did not find GDM is a risk factor for macrosomia or LGA after GDM treatment.
Pre-pregnancy obesity accounts for a high prevalence of macrosomia. Interventions that focus on pre-pregnancy obesity have the potential to reach far more women at risk of macrosomia.
确定妊娠期糖尿病（GDM）和孕前肥胖对巨大儿及大于胎龄儿（LGA）的影响。
2012年至2013年，我们对587例GDM女性和478例非GDM女性进行了一项前瞻性队列研究。收集她们的孕前体重数据、社会人口学数据、病史、临床治疗情况，并随访分娩结局包括出生体重。采用多因素logistic回归模型检验孕前肥胖与巨大儿/LGA之间以及GDM与巨大儿/LGA之间的关联。
在我们研究的1065例女性中，在调整了产妇年龄、孕周和GDM因素后，肥胖女性发生巨大儿（95%CI：2.52至6.91）和LGA（95%CI：1.60至3.21）的风险分别是非肥胖女性的4.17倍和2.27倍。在GDM治疗后，我们未发现GDM是巨大儿或LGA的危险因素。
孕前肥胖是巨大儿的高患病率原因。针对孕前肥胖的干预措施有可能惠及更多有巨大儿风险的女性。
