Vally Fatima, Presneill Jeffrey, Cade Thomas
Department of Maternal Fetal Medicine, Pregnancy Research Centre, Royal Women's Hospital, 20 Flemington Road, Parkville, Melbourne, VIC, Australia.
The Royal Melbourne Hospital, City Campus, 300 Grattan St, Melbourne, VIC, Australia.
J Pregnancy. 2017;2017:4935397. doi: 10.1155/2017/4935397. Epub 2017 Aug 27.
Current data on the rates of macrosomia in women with gestational diabetes mellitus (GDM) are heterogenous. No study has specifically examined macrosomia rates in women with diet-controlled gestational diabetes.
To compare the rates of macrosomia between mothers with diet-controlled GDM to mothers without diabetes mellitus.
A retrospective study in which all patients with diet-controlled GDM and singleton pregnancies in 2014 were considered for inclusion in the study. These cases were individually matched to mothers without GDM and without type 1 or 2 diabetes. Cases were matched to parity, age, and BMI. Controls were selected from the same year and as close as possible to the date of delivery of the case. Primary outcomes were macrosomia, defined by estimated fetal weight >90th centile and >95th centile (separately).
The estimated adjusted odds ratio for the presence of maternal GDM in the presence of EFW > 90th percentile (adjusted for maternal age, BMI, gravidity, parity, baby gender, and EGA) was 0.63 (95% CI 0.30-1.3; = 0.21). The estimated adjusted odds ratio for the association of maternal GDM and EFW > 95th percentile was 0.66 (95% CI 0.26-1.7; = 0.38).
Our findings suggest that macrosomia is not increased in women with diet-controlled GDM. The study registration number is AQA 16/01.
目前关于妊娠期糖尿病(GDM)女性巨大儿发生率的数据存在异质性。尚无研究专门调查饮食控制的妊娠期糖尿病女性的巨大儿发生率。
比较饮食控制的GDM母亲与非糖尿病母亲的巨大儿发生率。
一项回顾性研究,纳入2014年所有饮食控制的GDM单胎妊娠患者。这些病例与无GDM且无1型或2型糖尿病的母亲进行个体匹配。病例按产次、年龄和体重指数进行匹配。对照选自同一年,且尽可能接近病例的分娩日期。主要结局为巨大儿,分别定义为估计胎儿体重>第90百分位数和>第95百分位数。
在估计胎儿体重>第90百分位数时(根据母亲年龄、体重指数、孕次、产次、胎儿性别和孕周调整),母亲患GDM的估计调整比值比为0.63(95%可信区间0.30 - 1.3;P = 0.21)。母亲患GDM与估计胎儿体重>第95百分位数之间关联的估计调整比值比为0.66(95%可信区间0.26 - 1.7;P = 0.38)。
我们的研究结果表明,饮食控制的GDM女性中巨大儿发生率并未增加。研究注册号为AQA 16/01。