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糖化血红蛋白和 75 克口服葡萄糖耐量试验葡萄糖水平对出生体重百分位的影响。

The impact of glycosylated hemoglobin and 75-g oral glucose tolerance test glucose levels on birthweight percentile.

机构信息

Kocaeli University, Department of Obstetrics and Gynecology, Perinatology Unit - Kocaeli, Turkey.

Kocaeli University, Department of Obstetrics and Gynecology - Kocaeli, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2024 Sep 16;70(9):e20240466. doi: 10.1590/1806-9282.20240466. eCollection 2024.

Abstract

OBJECTIVE

Our research objective was to validate and contribute further evidence to the studies regarding large for gestational age and birthweight percentile by examining oral glucose tolerance test and glycosylated hemoglobin levels in both healthy women and those with gestational diabetes mellitus.

METHODS

This retrospective cohort study was conducted at a tertiary care hospital involving 106 women who delivered at gestational week 36 or later between February 2022 and February 2023. Maternal, obstetric, and neonatal data were collected from the participant's medical records. Large for gestational age and non-large for gestational age groups were compared. Correlation analysis was used to determine associations among oral glucose tolerance test, glycosylated hemoglobin levels, and the birthweight percentile.

RESULTS

Mothers of neonates in the large for gestational age category had higher body mass indexes before pregnancy (p=0.002) and delivery (p=0.003), as well as a higher incidence of gestational diabetes mellitus (p=0.027). Mothers of male large for gestational age infants had higher fasting plasma glucose and glycosylated hemoglobin levels compared to male non-large for gestational age infants (p=0.007 and p=0.004, respectively). There was a weak positive correlation between fasting plasma glucose levels and birthweight percentile in the overall group (r=0.342, p<0.006). Further analysis by gender showed a weak positive correlation between birthweight percentile and fasting plasma glucose and glycosylated hemoglobin values in male newborns (r=0.393, p=0.004 and r=0.373, p=0.006, respectively).

CONCLUSION

Our study has established a clear association between the birthweight percentile in male infants and the levels of glycosylated hemoglobin and fasting plasma glucose measured during oral glucose tolerance test. It is imperative to devise potential strategies aimed at achieving optimal glycosylated hemoglobin and fasting plasma glucose parameters to effectively reduce the frequency of large for gestational age in male infants.

摘要

目的

通过检查健康女性和妊娠期糖尿病女性的口服葡萄糖耐量试验和糖化血红蛋白水平,我们旨在验证和进一步证明有关巨大儿和出生体重百分位的研究,并为此做出贡献。

方法

这是一项在一家三级保健医院进行的回顾性队列研究,共纳入了 106 名在 2022 年 2 月至 2023 年 2 月期间分娩孕周为 36 周或以上的女性。从参与者的病历中收集了母亲、产科和新生儿数据。比较了巨大儿和非巨大儿组。采用相关分析来确定口服葡萄糖耐量试验、糖化血红蛋白水平与出生体重百分位之间的关联。

结果

巨大儿组新生儿的母亲在妊娠前(p=0.002)和分娩时(p=0.003)的体重指数更高,且妊娠期糖尿病的发病率更高(p=0.027)。与非巨大儿组的男性新生儿相比,巨大儿组的男性新生儿的空腹血糖和糖化血红蛋白水平更高(p=0.007 和 p=0.004)。总体而言,空腹血糖水平与出生体重百分位呈弱正相关(r=0.342,p<0.006)。按性别进一步分析显示,男性新生儿的出生体重百分位与空腹血糖和糖化血红蛋白值呈弱正相关(r=0.393,p=0.004 和 r=0.373,p=0.006)。

结论

我们的研究确立了男性婴儿的出生体重百分位与口服葡萄糖耐量试验中测量的糖化血红蛋白和空腹血糖水平之间的明确关联。制定旨在实现最佳糖化血红蛋白和空腹血糖参数的潜在策略至关重要,以有效降低男性巨大儿的发生率。

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