巨大儿高危因素临床分析

目的探讨巨大儿发生的高危因素。方法回顾性分析246例分娩巨大儿孕妇及200例分娩正常体重胎儿孕妇的年龄、孕周、孕产次、身高、宫高、腹围、胎儿双项径及妊娠合并症。结果2005年10月至2009年10月间巨大儿发生率有逐年上升的趋势，但各组闯比较无统计学意义。研究组平均年龄（28．32±3．12）岁；对照组平均年龄（28．53±2．87）岁。两组平均年龄相比无统计学意义（P〉O．05）。研究组年龄〉35岁患者明显高于对照组（P〈0．01）。研究组孕次平均为（2．21±1．13）次，对照组平均孕次为（1．52±0．93）次，两组相比有统计学意义（P〈0．05）。孕40周后巨大儿的发生比率升高，与对照组相比有统计学意义（P〈0．01）。研究组孕妇身高、宫高＋腹围及胎儿双顶径均明显高于对照组，两组相比有显著差异（P〈0．01）。研究组中糖尿病或GDM患者明显高于对照组，且血糖控制不良者明显高于对照组（P〈0．05）。结论巨大儿的发生与孕妇年龄、孕周、孕次产、身高、宫高、腹围、胎儿双顶径及糖尿病均有关系，掌握好巨大儿的高危因素和巨大儿的预测方法，对产前准确判断巨大儿具有重要作用。

Clinical Analysis of Risk Factors of Macrosomia

Objective To explore the risk factors of macrosomia. Methods Retrospective analysis of 246 cases of macrosomic pregnant women and 200 cases of normal birth weight pregnant women in age, fetal gestational age, times of parturition, height, high GTTS fetus, abdominal girth, and double top diameter and pregnancy complications. Results From October 2005 to October 2009, the macrosomic incidence was increasing, but the compasion between the groups had no statistical significance. The average age in the study group was 28. 32 ± 3.12, and 28.53 ± 2.87 in the control group, with no statistical significance （P〉 0.05） between the two groups. The age of more than 35 year-old patients was significantly higher than that of the control group （P 〈 0.01）. The average times of parturition werer 2.21 ± 1.13 in the study group and 1.52 ±0.93 in the control group, with statistical significance（P〈 0.05） between the two groups. 40 weeks later, the pregnant rate ofmacrosomia in the study group was statistically significant （P 〈 0.01） compared to the control group. The maternal height, the palace and fetal double top ± diameter in the study group were significantly higher than those in the control group, with significant difference between the two groups （P〈 0.01）. The diabetes patients or GDM were significantly more than those in the control group, and the poor blood glucose control was obviously higher than that of the control group （P〈 0.05）. Conclusion Macrosomic incidence was related with age, fetal gestational age, times of parturition, height, high GTTS fetus, abdominal girth, and double top diameter and diabetes. Mastering macrosomic risk factors and macrosomic forecast methods plays an important role in prenatal accurate judgement of macrosomia.