Rech F, Ippolito M, Cecchi A, Lojodice S, Indraccolo S R
Universita degli Studi di Roma "La Sapienza"--Roma Scuola Autonoma di Ostetricia di Camerino.
Minerva Ginecol. 1995 Nov;47(11):487-98.
Fetal megalosomia associates with an increased risk of maternal and perinatal pathology. However it is right to make a clear distinction between "physiologic" megalosomia, expression of a high genetic potential of growth from the fetus, and megalosomia referable to any maternal pathology. While the first one entails problems of obstetric management at the most, the second one compels to take measures in order to reduce its incidence. A sample of 45 fetuses with megalosomia was studied retrospectively and compared with a standard sample, randomly selected among the fetuses, term delivered, who in the same period considered (January 1990-January 1994) weighed less than 4 kg at birth. This was done in order to verify which of the risk factors of fetal megalosomia reported in the medical literature affects the most the people who address our Institute. Important risk factors resulted, besides maternal height and postdatism, pre-gestational overweight and obesity. The prognostic significance of the factors, such as advanced maternal age, multiparity, male sex of the unborn child, excessive maternal weight gain during pregnancy, previous megalosomia, was of more difficult interpretation. In our experience, gestational diabetes didn't play the role, universally recognized to it, of the most important risk factor of fetal megalosomia.
胎儿巨大儿与孕产妇及围产期病理状况风险增加相关。然而，明确区分“生理性”巨大儿（即胎儿生长遗传潜力高的表现）和与任何孕产妇病理状况相关的巨大儿是正确的。虽然前者最多只会带来产科管理方面的问题，但后者则需要采取措施以降低其发生率。对45例巨大儿胎儿样本进行了回顾性研究，并与一个标准样本进行比较，该标准样本是从同期（1990年1月至1994年1月）足月分娩且出生体重小于4千克的胎儿中随机选取的。这样做是为了核实医学文献中报道的胎儿巨大儿的哪些风险因素对前来我院就诊的人群影响最大。除了母亲身高和过期妊娠外，孕前超重和肥胖也是重要的风险因素。诸如母亲年龄偏大、多产、胎儿为男性、孕期母亲体重过度增加、既往有巨大儿史等因素的预后意义更难解读。根据我们的经验，妊娠期糖尿病并非普遍认为的胎儿巨大儿最重要的风险因素。
