Translational Medicine Center, Northwest Women's and Children's Hospital, No. 1616 Yanxiang Road, Xi'an 710061, China.
The Assisted Reproduction Center, Northwest Women's and Children's Hospital, No. 1616 Yanxiang Road, Xi'an 710061, China.
Int J Environ Res Public Health. 2023 Jan 24;20(3):2102. doi: 10.3390/ijerph20032102.
This study aimed to investigate the relationship between maternal blood glucose levels during pregnancy and neonatal birth outcomes in Northwest China.
This population-based cohort study included 10,010 first-trimester pregnant women who joined the birth cohort of the Northwest Women's and Children's Hospital from July 2018 to July 2020. Basic demographic characteristics, lifestyle and behavior patterns were collected. Oral glucose tolerance test (OGTT) results during the second trimester and pregnancy outcomes after childbirth were also collected. A generalized linear model was constructed to analyze the effects of blood glucose levels on neonatal birth outcomes.
We found that every 1 mmol/L increase in fasting plasma glucose (FPG) was associated with an increase in birth weight ( = 100.22 g, 95% confidence interval (): 81.91, 118.52), birth weight Z score ( = 0.23, : 0.19, 0.27) and birth weight Z centile ( = 6.72%, : 5.51, 7.94). Moreover, the risk of macrosomia, premature birth and being born large for gestational age (LGA) increased by 2.01 (: 1.67, 2.43), 1.35 (: 1.09, 1.66) and 1.80 (: 1.57, 2.07) times, respectively. Additionally, for every 1 mmol/L increase in FPG associated with a decrease in gestational age ( = -0.12 weeks, : -0.19, -0.06), the risk of SGA decreased by 0.70 ( = 0.70, : 0.55, 0.89) times. Every 1 mmol/L increase in 1/2-h PG had similar outcomes as FPG, besides premature birth and SGA.
Higher blood glucose in pregnant women may increase neonatal birth weight, decrease gestational age and lead to a higher risk of macrosomia, premature birth and LGA. Mothers should actively prevent and control hyperglycemia to promote maternal and infant health.
本研究旨在探讨中国西北地区孕妇孕期血糖水平与新生儿出生结局的关系。
本基于人群的队列研究纳入了 2018 年 7 月至 2020 年 7 月期间参加西北妇女儿童医院生育队列的 10010 名孕早期孕妇。收集了基本人口统计学特征、生活方式和行为模式。还收集了孕中期口服葡萄糖耐量试验（OGTT）结果和产后妊娠结局。构建了广义线性模型来分析血糖水平对新生儿出生结局的影响。
我们发现，空腹血糖（FPG）每增加 1mmol/L，出生体重（ = 100.22g，95%置信区间（CI）：81.91，118.52）、出生体重 Z 评分（ = 0.23，95%CI：0.19，0.27）和出生体重 Z 百分位数（ = 6.72%，95%CI：5.51，7.94）均增加。此外，巨大儿、早产和出生体重大于胎龄（LGA）的风险分别增加 2.01（95%CI：1.67，2.43）、1.35（95%CI：1.09，1.66）和 1.80（95%CI：1.57，2.07）倍。此外，FPG 每增加 1mmol/L，与胎龄减少 0.12 周（ = -0.12 周，95%CI：-0.19，-0.06）相关，SGA 的风险降低 0.70（95%CI：0.70，0.55，0.89）倍。1/2 小时 PG 每增加 1mmol/L，除早产和 SGA 外，与 FPG 有相似的结果。
孕妇血糖升高可能会增加新生儿出生体重，减少胎龄，并导致巨大儿、早产和 LGA 的风险增加。母亲应积极预防和控制高血糖，以促进母婴健康。
