根据母亲体重状况探讨母亲低血糖与小于胎龄儿之间的关系：一项在两家医院开展的回顾性队列研究
Relationship between maternal hypoglycaemia and small-for-gestational-age infants according to maternal weight status: a retrospective cohort study in two hospitals.
作者信息
Shinohara Satoshi, Uchida Yuzo, Hirai Mitsuo, Hirata Shuji, Suzuki Kohta
机构信息
Department of Obstetrics and Gynecology, Yamanashi Prefectural Central Hospital, Kofu, Japan.
Department of Obstetrics and Gynecology, Kofu Municipal Hospital, Kofu, Japan.
出版信息
BMJ Open. 2016 Dec 2;6(12):e013749. doi: 10.1136/bmjopen-2016-013749.
OBJECTIVE
The relationship between pre-pregnancy body mass index (BMI) and low glucose challenge test (GCT) results by maternal weight status has not been examined. This study aimed to clarify the relationship between a low GCT result and small for gestational age (SGA) by maternal weight status.
DESIGN
A retrospective cohort study in 2 hospitals.
SETTING
This study evaluated the obstetric records of women who delivered in a general community hospital and a tertiary perinatal care centre.
PARTICIPANTS
The number of women who delivered in both hospitals between January 2012 and December 2013 and underwent GCT between 24 and 28 weeks of gestation was 2140. Participants with gestational diabetes mellitus or diabetes during pregnancy, and GCT results of ≥140 mg/dL were excluded. Finally, 1860 women were included in the study.
PRIMARY AND SECONDARY OUTCOME MEASURES
The participants were divided into low-GCT (≤90 mg/dL) and non-low-GCT groups (91-139 mg/dL). The χ tests and multivariate logistic regression analyses were conducted to investigate the association between low GCT results and SGA by maternal weight status.
RESULTS
The incidence of SGA was 11.4% (212/1860), and 17.7% (330/1860) of the women showed low GCT results. The patients were divided into 3 groups according to their BMI (underweight, normal weight and obese). When the patients were analysed separately by their weight status after controlling for maternal age, pre-pregnancy maternal weight, maternal weight gain during pregnancy, pregnancy-induced hypertension, thyroid disease and difference in hospital, low GCT results were significantly associated with SGA (OR 2.10; 95% CI 1.14 to 3.89; p=0.02) in the underweight group.
CONCLUSIONS
Low GCT result was associated with SGA at birth among underweight women. Examination of maternal glucose tolerance and fetal growth is necessary in future investigations.
目的
孕前体重指数（BMI）与根据孕妇体重状况得出的低葡萄糖耐量试验（GCT）结果之间的关系尚未得到研究。本研究旨在阐明根据孕妇体重状况得出的低GCT结果与小于胎龄儿（SGA）之间的关系。
设计
在两家医院进行的一项回顾性队列研究。
背景
本研究评估了在一家普通社区医院和一家三级围产期护理中心分娩的妇女的产科记录。
参与者
2012年1月至2013年12月期间在两家医院分娩且在妊娠24至28周接受GCT的妇女数量为2140名。排除患有妊娠期糖尿病或孕期糖尿病以及GCT结果≥140mg/dL的参与者。最终，1860名妇女被纳入研究。
主要和次要观察指标
参与者被分为低GCT组（≤90mg/dL）和非低GCT组（91 - 139mg/dL）。进行χ检验和多因素逻辑回归分析，以研究根据孕妇体重状况得出的低GCT结果与SGA之间的关联。
结果
SGA的发生率为11.4%（212/1860），17.7%（330/1860）的妇女GCT结果较低。根据BMI将患者分为3组（体重过轻、正常体重和肥胖）。在控制产妇年龄、孕前产妇体重、孕期体重增加、妊娠期高血压、甲状腺疾病和医院差异后，按体重状况分别分析患者时，体重过轻组中低GCT结果与SGA显著相关（OR 2.10；95%CI 1.14至3.89；p = 0.02）。
结论
体重过轻的妇女中，低GCT结果与出生时的SGA相关。在未来的研究中，有必要检查孕妇的糖耐量和胎儿生长情况。
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