College of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
Zhengzhou Central Hospital, Zhengzhou, Henan, China.
PLoS One. 2021 Apr 30;16(4):e0251024. doi: 10.1371/journal.pone.0251024. eCollection 2021.
To explore the factors affecting neonatal physical development in pregnant women with or without gestational diabetes mellitus (GDM).
The subjects were selected from the pregnant woman giving birth in 2nd Affiliated Hospital of Zhengzhou University, from November 2015 to May 2016. The age, occupation, education level, gestational age, body weight before pregnancy, body weight at delivery, body height, delivery pattern, GDM status of pregnant women and neonatal gender, birth weight (BW), chest circumference (CC), head circumference (HC) and birth length (BL) were collected through medical records and questionnaires. The clinical data were retrospectively analyzed and studied.
The significant differences were found between women with GDM and without GDM in following neonatal variables (P<0.05): BW, CC, and HC. GDM status increased the incidence of macrosomia (OR = 2.241, 95% CI: 1.406-3.573), large CC (OR = 2.470, 95% CI: 1.687-3.6153). Gestational weight gain (GWG) above IOM guideline was risk factor for macrosomia (OR = 1.763, 95% CI:1.098-2.833), large HC (OR = 1,584, 95% CI: 1.093-2.296) and large CC (OR = 1.707, 95% CI:1.163-2.506). Underweight was risk factor for short BL (OR = 2.543, 95% CI:1.161-5.571) and small CC (OR = 1.901, 95% CI:1.064-3.394). Female neonate was prone to appear short BL(OR = 2.831, 95% CI: 1.478-5.422) and small HC (OR = 2.750, 95% CI: 1.413-5.350), and not likely to macrosomia (OR = 0.538, 95% CI: 0.343-0.843), longer BL (OR = 0.584, 95% CI: 0.401-0.850), large HC (OR = 0.501, 95% CI: 0.352-0.713), and (OR = 0.640, 95% CI: 0.446-0.917). For women with GDM, gestational age was an risk factor of neonatal BW (low BW: OR = 0.207, 95% CI: 0.085-0.503; macrosomia: OR = 1.637, 95% CI: 1.177-2.276), BL (short BL: OR = 0.376, 95% CI: 0.241-0.585; long BL: OR = 1.422, 95% CI: 1.054-1.919), HC (small HC: OR = 0.343, 95% CI: 0.202-0.583; large HC: OR = 1.399, 95% CI: 1.063-1.842) and CC (small CC: OR = 0.524, 95% CI: 0.374-0.733; large CC: OR = 1.485, 95% CI: 1.138-1.936).
In our study, gestational age, GDM status, neonatal gender, GWG and pre-pregnancy body mass index (BMI) are associated the abnormal physical development of neonates. In women with GDM, gestational age was correlate with neonatal abnormal physical developments.
探讨患有或不患有妊娠期糖尿病(GDM)的孕妇对新生儿体格发育的影响因素。
选取 2015 年 11 月至 2016 年 5 月在郑州大学第二附属医院分娩的孕妇为研究对象。通过病历和问卷调查收集孕妇的年龄、职业、教育水平、孕周、孕前体重、分娩体重、身高、分娩方式、GDM 状态、新生儿性别、出生体重(BW)、胸围(CC)、头围(HC)和出生体长(BL)等临床资料。对这些临床数据进行回顾性分析和研究。
患有 GDM 的孕妇与不患有 GDM 的孕妇在以下新生儿变量方面存在显著差异(P<0.05):BW、CC 和 HC。GDM 状态增加了巨大儿(OR=2.241,95%CI:1.406-3.573)、大 CC(OR=2.470,95%CI:1.687-3.6153)的发生几率。IOM 指南建议的 GWG 增加是巨大儿(OR=1.763,95%CI:1.098-2.833)、大 HC(OR=1,95%CI:1.093-2.296)和大 CC(OR=1.707,95%CI:1.163-2.506)的危险因素。低体重是短 BL(OR=2.543,95%CI:1.161-5.571)和小 CC(OR=1.901,95%CI:1.064-3.394)的危险因素。女性新生儿易出现短 BL(OR=2.831,95%CI:1.478-5.422)和小 HC(OR=2.750,95%CI:1.413-5.350),不易出现巨大儿(OR=0.538,95%CI:0.343-0.843)、较长 BL(OR=0.584,95%CI:0.401-0.850)、大 HC(OR=0.501,95%CI:0.352-0.713)和(OR=0.640,95%CI:0.446-0.917)。对于患有 GDM 的孕妇,孕周是 BW 新生儿(低 BW:OR=0.207,95%CI:0.085-0.503;巨大儿:OR=1.637,95%CI:1.177-2.276)、BL(短 BL:OR=0.376,95%CI:0.241-0.585;长 BL:OR=1.422,95%CI:1.054-1.919)、HC(小 HC:OR=0.343,95%CI:0.202-0.583;大 HC:OR=1.399,95%CI:1.063-1.842)和 CC(小 CC:OR=0.524,95%CI:0.374-0.733;大 CC:OR=1.485,95%CI:1.138-1.936)的危险因素。
在本研究中,孕周、GDM 状态、新生儿性别、GWG 和孕前 BMI 与新生儿体格发育异常有关。在患有 GDM 的孕妇中,孕周与新生儿体格发育异常相关。