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患有糖尿病的孕妇所生婴儿出生体重相关的临床因素。

Clinical factors associated with birth weight of infants born to pregnant women with diabetes.

作者信息

Suzuki Tomoko, Yanagisawa Keiko, Kakogawa Jun, Babazono Tetsuya

机构信息

Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan.

Maternal and Perinatal Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

出版信息

Diabetol Int. 2023 Oct 17;15(2):177-186. doi: 10.1007/s13340-023-00667-5. eCollection 2024 Apr.

Abstract

We aimed to examine the clinical factors associated with the birth weight of infants born to Japanese pregnant women with diabetes. This retrospective observational study enrolled 204 Japanese women with singleton pregnancies with type 1 diabetes (n = 135) or type 2 diabetes (n = 69). We used multiple regression analyses to examine factors associated with birth weight standard deviation (SD) scores. In addition, we compared the clinical findings among the groups of mothers who gave birth to appropriate for gestational age infants (AGA group), large for gestational age infants (LGA group), and small for gestational age infants (SGA group). Multiple regression analyses showed that the birth weight SD score was positively associated with type 2 diabetes. In women with type 1 diabetes, the birth weight SD score was positively associated with glycated albumin levels and gestational weight gain and negatively associated with pre-pregnancy underweight. Only gestational weight gain was positively associated with birth weight SD scores in women with type 2 diabetes. Glycated hemoglobin levels, gestational weight gain, and triglyceride levels were significantly higher in the LGA group than in the AGA group. The SGA group showed significantly lower gestational weight gain and triglyceride levels than the AGA group. These results suggest that it is important to manage not only blood glucose levels but also pre-pregnancy body weight and gestational weight gain for appropriate fetal growth. The effects of clinical factors on infant birth weight may differ between patients with type 1 and those with type 2 diabetes.

摘要

我们旨在研究与日本糖尿病孕妇所分娩婴儿出生体重相关的临床因素。这项回顾性观察性研究纳入了204例单胎妊娠的日本女性,其中1型糖尿病患者135例,2型糖尿病患者69例。我们使用多元回归分析来研究与出生体重标准差(SD)评分相关的因素。此外,我们比较了分娩出适于胎龄儿(AGA组)、大于胎龄儿(LGA组)和小于胎龄儿(SGA组)的母亲群体之间的临床发现。多元回归分析显示,出生体重SD评分与2型糖尿病呈正相关。在1型糖尿病女性中,出生体重SD评分与糖化白蛋白水平和孕期体重增加呈正相关,与孕前体重过轻呈负相关。在2型糖尿病女性中,只有孕期体重增加与出生体重SD评分呈正相关。LGA组的糖化血红蛋白水平、孕期体重增加和甘油三酯水平显著高于AGA组。SGA组的孕期体重增加和甘油三酯水平显著低于AGA组。这些结果表明,为了实现胎儿的正常生长,不仅要控制血糖水平,还要管理孕前体重和孕期体重增加。临床因素对婴儿出生体重的影响在1型糖尿病患者和2型糖尿病患者中可能有所不同。

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Japanese Clinical Practice Guideline for Diabetes 2019.《2019年日本糖尿病临床实践指南》
Diabetol Int. 2020 Jul 24;11(3):165-223. doi: 10.1007/s13340-020-00439-5. eCollection 2020 Jul.
3
Fetal overgrowth in women with type 1 and type 2 diabetes mellitus.1型和2型糖尿病女性的胎儿过度生长。
PLoS One. 2017 Nov 9;12(11):e0187917. doi: 10.1371/journal.pone.0187917. eCollection 2017.
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Pregnancy Outcomes Based on Pre-Pregnancy Body Mass Index in Japanese Women.基于日本女性孕前体重指数的妊娠结局
PLoS One. 2016 Jun 9;11(6):e0157081. doi: 10.1371/journal.pone.0157081. eCollection 2016.

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