Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.
School of Health Services Management, Anhui Medical University, Hefei, China.
J Matern Fetal Neonatal Med. 2020 Nov;33(21):3549-3558. doi: 10.1080/14767058.2019.1578746. Epub 2019 Feb 17.
This study aims to estimate the prevalence and risk factors of macrosomia and LGA (large for gestational age) in non-GDM (gestational diabetes mellitus) pregnant women in Fuyang, Anhui Province of China. A large population-based cohort study was conducted among non-GDM pregnant women aged 18-45 years. Maternal sociodemographic data prior to pregnancy were collected using interviewer-administered standardized questionnaire. Maternal obstetrical delivery records and newborn hospital records were extracted from antenatal care booklets and hospital discharge abstracts. Logistic regression analysis was used to identify the predictors of macrosomia and LGA. The incidence of macrosomia and LGA was 9.2 and 15.9%, respectively. Mothers ≥35 years of age (aOR 2.75, 95% CI 1.98, 3.80), male neonates (aOR 1.68, 95% CI 1.51, 1.89), overweight and obese (aOR 1.61, 95% CI 1.34, 1.92 and aOR 3.05, 95% CI 2.05, 4.56, respectively) were associated with increased risk of macrosomia. Compared with the less educated mothers, the educated mothers were more likely to have increased risk of macrosomia. IFA (iron and folic acid) supplements intake during pregnancy was more likely to deliver macrosomia or LGA (aOR1.32, 95% CI 1.08, 1.49 and aOR1.42, 95% CI 1.24, 1.61, respectively) as compared with no IFA supplements intake. SCr (serum creatinine concentration) >80 µmol/L was related to decreased risk of macrosomia (aOR 0.73, 95% CI 0.61, 0.86) and LGA (aOR 0.67, 95% CI 0.59, 0.77) as compared with normal range (44-80 µmol/L). There was a high prevalence of macrosomia and LGA in non-GDM pregnant women in China. Healthcare educations and reasonable body weight are necessary for pregnant women to prevent macrosomia and LGA. Pregnant women should be checked regularly and have the first prenatal visit as soon as possible.
本研究旨在估计中国安徽省阜阳市非妊娠糖尿病（gestational diabetes mellitus，GDM）孕妇中巨大儿和 LGA（大于胎龄儿）的患病率和危险因素。对年龄在 18-45 岁之间的非 GDM 孕妇进行了一项基于人群的大型队列研究。使用访谈者管理的标准化问卷收集孕妇妊娠前的社会人口统计学数据。从产前保健手册和医院出院摘要中提取产妇产科分娩记录和新生儿医院记录。采用 logistic 回归分析识别巨大儿和 LGA 的预测因素。巨大儿和 LGA 的发生率分别为 9.2%和 15.9%。年龄≥35 岁的母亲（aOR 2.75，95%CI 1.98，3.80）、男婴（aOR 1.68，95%CI 1.51，1.89）、超重和肥胖（aOR 1.61，95%CI 1.34，1.92 和 aOR 3.05，95%CI 2.05，4.56）与巨大儿风险增加相关。与受教育程度较低的母亲相比，受教育程度较高的母亲更有可能增加巨大儿的风险。与不服用 IFA（铁和叶酸）补充剂相比，怀孕期间服用 IFA 补充剂更有可能导致巨大儿或 LGA（aOR1.32，95%CI 1.08，1.49 和 aOR1.42，95%CI 1.24，1.61）。与正常范围（44-80μmol/L）相比，血清肌酐浓度（serum creatinine concentration，SCr）>80μmol/L 与巨大儿（aOR 0.73，95%CI 0.61，0.86）和 LGA（aOR 0.67，95%CI 0.59，0.77）的风险降低相关。中国非 GDM 孕妇巨大儿和 LGA 的患病率较高。医疗保健教育和合理的体重对孕妇预防巨大儿和 LGA 是必要的。孕妇应定期检查，并尽快进行首次产前检查。
