Chen X L, Han Y, Zhao X M, Liu Y, Lü J J
Huangyan Hospital Affiliated to Wenzhou Medical University, Zhejiang Taizhou 318020, China; the Second Hospital Affiliated to Wenzhou Medical University, Zhejiang Wenzhou 325000, China.
Zhonghua Yi Xue Za Zhi. 2017 Jan 3;97(1):38-42. doi: 10.3760/cma.j.issn.0376-2491.2017.01.010.
To explore the correlation among the pre-pregnant body mass index (BMI), gestational weight gain (GWG) and umbilical cord blood C peptide, and to investigate the influence of maternal weight management on the incidence of baby long-term metabolic syndrome. During May to Aug.2015, 485 pregnant women in Zhejiang Taizhou first people's hospital and Taizhou Huangyan maternal &child care service centre were selected in random and divided into four groups according to pre-pregnant BMI: low body mass, normal body mass, over body mass and obese group, and also divided into two groups for getting gestational diabetes mellitus (GDM) or not. According to the gestational weight gain (GWG), all the cases were divided into two groups: above the Institute Of Medicine (IMO) 2009 recommendations or not. According to the outcome, the GDM group which had received weight control treatment, was divided into successful treat group or not. At last, we tested the umbilical cord blood C peptide and birth weight of each newborn and compared the difference in all subgroups. The correlation between the umbilical cord blood C peptide and birth weight were analysed. (1) In the pre-pregnant BMI groups, there were significant differences of incidence of GDM (<0.05). But, there were no significant differences of incidence of GWG in four groups (>0.05). (2) Newborn birth weight and the umbilical cord blood C peptide were positively correlated (=0.673, <0.05). (3) Umbilical cord blood C peptide showed the correlation in all subgroups for different pre-pregnant BMI, GDM or not, overweight or not (<0.05), but only the GDM or not group had relation to newborn birth weight in all subgroups. (4) All groups showed correlations with neonatal umbilical cord blood C peptide, the GDM mostly (β=0.58), pre-pregnant BMI secondly (β: 0.36, 0.38) , and GWG weakly (β=0.17). (5) By stratification analysis, in GDM group, low body mass was negatively correlated with umbilical cord blood C peptide (<0.05, β=-1.41); in non-GDM group, over body mass group and obsess group were positively correlated with umbilical cord blood C peptide (<0.05, β=0.37, 0.46). There was direct correlation between the pre-pregnant body mass index, the gestational weight gain and umbilical cord blood C peptide. Suitable maternal weight control especially pre-pregnant body mass index control will lower the baby long-term metabolic syndrome incidence.
探讨孕前体重指数（BMI）、孕期体重增加（GWG）与脐血C肽之间的相关性，并研究孕期体重管理对婴儿远期代谢综合征发生率的影响。2015年5月至8月，随机选取浙江省台州市第一人民医院及台州市黄岩区妇幼保健院的485例孕妇，根据孕前BMI分为四组：低体重组、正常体重组、超重组和肥胖组，又根据是否患妊娠期糖尿病（GDM）分为两组。根据孕期体重增加情况（GWG），将所有病例分为两组：是否高于医学研究所（IMO）2009年推荐值。根据结局，将接受体重控制治疗的GDM组分为治疗成功组和未成功组。最后，检测各新生儿的脐血C肽和出生体重，并比较所有亚组间的差异。分析脐血C肽与出生体重之间的相关性。（1）在孕前BMI组中，GDM发生率存在显著差异（<0.05）。但四组孕期体重增加发生率无显著差异（>0.05）。（2）新生儿出生体重与脐血C肽呈正相关（=0.673，<0.05）。（3）脐血C肽在不同孕前BMI、是否患GDM、是否超重的所有亚组中均显示出相关性（<0.05），但仅是否患GDM组在所有亚组中与新生儿出生体重有关。（4）所有组均与新生儿脐血C肽相关，GDM组相关性最强（β=0.58），孕前BMI次之（β：0.36，0.38），GWG相关性最弱（β=0.17）。（5）通过分层分析，在GDM组中，低体重组与脐血C肽呈负相关（<0.05，β=-1.41）；在非GDM组中，超重组和肥胖组与脐血C肽呈正相关（<0.05，β=0.37，0.46）。孕前体重指数、孕期体重增加与脐血C肽之间存在直接相关性。适当的孕期体重控制尤其是孕前体重指数控制将降低婴儿远期代谢综合征的发生率。
