Hur Junguk, Cho Eun-Hee, Baek Kwang-Hyun, Lee Kyung Ju
Department of Biomedical Sciences, University of North Dakota, Grand Forks, North Dakota, USA.
Department of Internal Medicine, Kangwon National University, Chuncheon, Republic of Korea.
Int J Med Sci. 2017 Feb 7;14(2):123-127. doi: 10.7150/ijms.17321. eCollection 2017.
The aim of this study was to evaluate the association between maternal serum estriol levels, which are routinely measured in the first trimester of pregnancy, and adverse pregnancy outcomes including gestational diabetes. We performed a retrospective chart analysis of women who delivered between July 1, 2007, and December 31, 2009, at Kangnam CHA Medical Center in Seoul, Korea. Only patients with available estriol measurements during their pregnancies and complete follow-up data were included in the study. The effect of estriol on the incidence of adverse pregnancy outcomes was examined using multinomial logistic regression analysis with age and pre-pregnancy body mass index (BMI) as covariates. The total number of subjects was 1,553, the mean age was 32.9 ± 3.7 years, and the mean pre-pregnancy BMI was 21.2 ± 3.0 kg/m. Unconjugated estriol > 95 percentile of the screened population or unconjugated estriol ≥ 2.0 MoM (Multiple of the Median) was significantly associated with an increased risk for developing gestational diabetes mellitus (GDM), after adjusting for age and pre-pregnancy maternal weight. High levels of unconjugated estriol in the maternal serum during the early second trimester of pregnancy are a useful predictor of GDM development.
本研究的目的是评估孕期头三个月常规检测的孕妇血清雌三醇水平与包括妊娠期糖尿病在内的不良妊娠结局之间的关联。我们对2007年7月1日至2009年12月31日在韩国首尔江南CHA医疗中心分娩的妇女进行了一项回顾性病历分析。本研究仅纳入了孕期有可用雌三醇测量值且有完整随访数据的患者。以年龄和孕前体重指数（BMI）作为协变量，采用多项逻辑回归分析来检验雌三醇对不良妊娠结局发生率的影响。研究对象总数为1553人，平均年龄为32.9±3.7岁，孕前平均BMI为21.2±3.0kg/m²。在调整年龄和孕前孕妇体重后，未结合雌三醇>筛查人群第95百分位数或未结合雌三醇≥2.0MoM（中位数倍数）与发生妊娠期糖尿病（GDM）的风险增加显著相关。妊娠中期早期孕妇血清中高水平的未结合雌三醇是GDM发生的一个有用预测指标。
