Facultad de Medicina UNNE, Corrientes, Argentina.
Hospital Enrique Tornu, CABA, Buenos Aires, Argentina.
Diabetes Metab Res Rev. 2020 Jul;36(5):e3302. doi: 10.1002/dmrr.3302. Epub 2020 Mar 5.
Offspring of women with gestational diabetes (GD) have more macrosomia than newborns of normal mothers. We studied macrosomia frequency, possible pathogenesis, and main predictors of its appearance at different gestational ages.
A total of 1870 pregnant women with GD were recruited in primary care centres and maternity hospitals in the Argentine provinces of Corrientes, Chaco, Buenos Aires, and in Buenos Aires City; 1088 completed gestation and delivered an infant. We collected clinical and metabolic data, personal and obstetric history, and gestational and delivery characteristics. Presence of macrosomia was analysed in the whole population, the entire pregnancy, and in each trimester of gestation. Data were statistically analysed and values were expressed as mean ± SD and percentages. The study protocol was approved by the Ethics Committee and all participants signed informed consent.
Macrosomia was found in 12.9% of newborns and obesity in all mothers with no significant differences between mothers with/without macrosomic offspring. In early pregnancy, the main significant indicators of macrosomia were: history of dyslipidaemia (5.6% vs 1.2%, respectively) and macrosomia in previous pregnancies (27% vs 13%, respectively). However, the third trimester showed a significant combination of higher BMI, FBG, and triglycerides.
Offspring of women with GD presented macrosomia in 12.9% of cases, maternal history of dyslipidaemia and macrosomia in previous pregnancies being early predictors. The combination of maternal obesity, FBG, and hypertriglyceridemia became significant during the last trimester of pregnancy.
患有妊娠糖尿病（gestational diabetes，GD）的女性所生子女比正常母亲的新生儿更容易出现巨大儿。我们研究了巨大儿的发生频率、可能的发病机制，以及不同孕龄时其出现的主要预测因素。
我们在阿根廷科连特斯省、查科省、布宜诺斯艾利斯省和布宜诺斯艾利斯市的基层医疗中心和妇产科医院招募了 1870 名患有 GD 的孕妇，其中 1088 名孕妇完成了妊娠并分娩了婴儿。我们收集了临床和代谢数据、个人和产科史以及妊娠和分娩特征。在整个人群、整个孕期和每个孕龄期分析巨大儿的存在情况。数据进行了统计学分析，数值以均数±标准差和百分比表示。该研究方案得到了伦理委员会的批准，所有参与者均签署了知情同意书。
新生儿巨大儿的发生率为 12.9%，所有患有 GD 的母亲均肥胖，但巨大儿母亲与非巨大儿母亲之间无显著差异。在孕早期，巨大儿的主要显著指标为：血脂异常史（分别为 5.6%和 1.2%）和既往妊娠巨大儿史（分别为 27%和 13%）。然而，在孕晚期，BMI、空腹血糖和甘油三酯升高的组合具有显著意义。
患有 GD 的女性所生子女中，12.9%存在巨大儿，母亲血脂异常史和既往妊娠巨大儿史是早期预测因素。在妊娠晚期，母亲肥胖、空腹血糖和高甘油三酯血症的组合变得显著。
