不同分娩方式足月新生儿生后早期血糖变化

目的探讨不同分娩方式足月新生儿生后早期微量血糖的变化。方法选择2011年12月—2012年2月娩出的足月新生儿,其中剖宫产60例(择期剖宫产36例,应急剖宫产24例),自然分娩44例,监测分娩即刻孕母末梢血糖,新生儿脐血血糖及其生后0.5、2、6、12、24 h动态血糖。结果剖宫产儿脐血及0.5、2、6、12、24 h的血糖值均明显低于自然分娩儿,差异有统计学意义(P均<0.05);且择期剖宫产儿脐血及2、6 h的血糖值均低于应急剖宫产儿,差异有统计学意义(P<0.01),而生后0.5 h血糖值择期剖宫产儿高于应急剖宫产儿,差异有统计学意义(P<0.05),生后12、24h的血糖值差异无统计学意义(P>0.05);分娩前空腹低血糖母亲的剖宫产儿的脐血及生后0.5、2、6、12、24 h的血糖值均低于自然分娩儿,差异有统计学意义(P均<0.05)。结论部分足月新生儿存在生后早期发生低血糖的可能,剖宫产儿发生低血糖的可能性大于自然分娩儿,自然分娩和择期剖宫产儿低血糖多发生在生后2 h左右,而应急剖宫产儿多发生在0.5 h左右;与自然分娩相比孕母分娩前空腹低血糖对剖宫产儿的影响更大。     

糖尿病母亲婴儿低血糖发生情况及其与脑损伤的关系

目的探讨糖尿病母亲婴儿（IDMS）低血糖的发生情况及其与脑损伤的关系。方法分析86例IDMS低血糖的发生情况、母亲孕期血糖控制与低血糖持续时间的关系。分析其脑损伤发生及严重程度与低血糖持续时间、并其他疾病和症状性低血糖的关系。结果短暂性低血糖75例（87.2%）,反复发作性低血糖11例（12.8%）。母亲孕期血糖反复发作性低血糖发生率控制不满意组为19.4%,满意组为8%。反复发作性低血糖组脑损伤总发生率及重度脑损伤发生率高于短暂性低血糖组,并其他疾病组48.5%和无临床症状组57.4%,均有显著性差异（Pa〈0.05）。结论低血糖的持续时间与母亲妊娠期血糖控制情况及脑损伤发生、严重程度有关;低血糖并其他疾病会加重脑损伤,症状性低血糖时常存在严重脑损伤。     

孕期营养干预和代谢性危险因素对妊娠结局的影响

目的 探讨孕期营养干预和孕期代谢性危险因素对妊娠结局的影响。方法 研究对象为上海市国际和平妇幼保健院2010年5月至2012年4月接受常规产检并且分娩的孕妇。采用回顾性队列研究,在确诊为妊娠糖尿病(GDM)的孕妇中比较膳食干预组(接受膳食咨询) 和对照组(未接受膳食咨询)不良妊娠结局的差异,GDM诊断采用2010年国际糖尿病与妊娠研究组推荐标准。采用Logistics逐步回归分析母亲孕期危险因素对巨大儿发生的影响及作用大小。结果 ①10 421名孕妇的围生期信息进入数据分析。孕妇初诊时平均孕周20.8(19.4~22.4)周,初诊时空腹血糖(FBS)、三酰甘油(TG)和总胆固醇(CHOL)平均水平分别为(4.3±0.4)、(1.3±0.6)和(4.7±0.8) mmol·L-1,收缩压和舒张压的平均水平分别为(111.3±11.5)和(67.9±13.3)mmHg。高危孕妇的GDM的患病率为15.8%。新生儿平均出生体重(3 355.4±426.0) g,巨大儿发生率6.2%。②812名GDM孕妇中,干预组570例,对照组242例。两组孕妇年龄、文化程度、孕20周体重、初诊时血糖、血脂等基线水平均衡可比。干预组的新生儿出生体重、巨大儿发生率和妊娠期高血压发生率均低于对照组,分别为(3 347.4±19.6) vs (3 450.3±35.6) g(P=0.007)、6.7% vs 15.6%(P=0.001)和26.3% vs 47.9% (P<0.001)。随着营养干预次数的增加,孕中晚期体重增长量和新生儿出生体重均呈下降趋势(r=-0.126,P=0.003;r=-0.112,P=0.002),巨大儿的发生率也依次降低。③Logistic逐步回归分析显示,孕20周时体重(OR=1.08,95%CI:1.07～1.09)、孕中晚期体重增长量(OR=1.10,95%CI:1.07~1.12)和GDM(OR=1.63,95%CI:1.22~2.19)是巨大儿发生的危险因素。结论 对高危孕妇应考虑进行更早期的孕期危险因素管理以及膳食指导干预,控制孕期体重合理增长,有望减少不良妊娠结局的发生。     

巨大儿与正常出生体质量儿生后早期微量血糖变化

目的探讨巨大儿与正常出生体质量儿生后3d内微量血血糖变化。方法采用德国保灵曼公司生产的电子感应微量血糖测定仪对本院出生巨大儿111例、正常出生体质量儿236例于生后2、4、12、24、72h测定微量血糖,并进行统计分析。结果巨大儿生后2h血糖为(2.39±0.66)mmol/L,明显低于正常出生体质量儿(3.06±0.80)mmol/L(P<0.001),4h血糖为(2.92±0.68)mmol/L,低于正常出生体质量儿(3.10±0.75)mmol/L(P<0.05),其低血糖发生率(11.7%)明显高于正常出生体质量儿(0.4%)。结论巨大儿生后4h内较正常出生体质量儿更易发生低血糖,监测血糖是预防新生儿生后早期低血糖发生的最好方法。     

孕前体重及孕期体重增长与巨大儿发生的关系

目的 研究孕前体重状况与孕期体重增长与巨大儿发生的关系。方法 以上海2家医院健康产妇为研究对象。采集产妇指标（年龄、身高、孕前BMI、文化程度、既往疾病史、分娩前体重、血三酰甘油）和新生儿指标（性别、出生体重、出生身长、出生孕周）。采用二项Logistic回归进行多因素分析。以孕前BMI分组,将新生儿是否为巨大儿作为因变量,孕期增重作为检验变量,对孕前营养不良、正常和超重（肥胖）组分别使用ROC曲线计算界值,得出孕期合理体重增长的上限值。结果 共纳入1 286例产妇,平均年龄（28.8±3.7）岁。孕前营养不良、正常和超重(肥胖)组分别为239例（18.6%）、872例（67.8%）和175例（13.6%）。孕期平均增重（15.4±4.7） kg,其中孕期体重增长过少206例（16.0%）、正常488例（37.9%）、过多592例（46.0%）。新生儿出生体重（3 380±384）g,巨大儿发生率6.0%（77/1 286）。孕前营养不良、正常和超重（肥胖）组巨大儿发生率分别为2.9%（7/239）、5.6%（49/872）和12.0%（21/175）。巨大儿产妇孕周、孕前BMI、孕期增重、高三酰甘油血症发生率均明显高于正常出生体重儿产妇。多因素Logistic分析显示孕前超重、孕周增加、孕期体重增长过多和高三酰甘油血症是巨大儿发生的危险因素。孕前营养不良、正常和超重（肥胖）组孕期体重增重界值分别为20.8、14.8和15.3 kg。结论 孕前超重、孕周增加、孕期体重增长过多和高三酰甘油血症与巨大儿发生相关。     

新生儿低血糖的研究进展

葡萄糖是人体能量代谢尤其是脑能量代谢的重要物质。新生儿低血糖对脑发育和脑功能有损害 ,因此 ,对新生儿低血糖应予重视。近年来的研究对新生儿低血糖有了进一步的认识。1　新生儿低血糖的概述新生儿出生后 3ｄ内糖代谢的调节功能差 ,尤其是低出生体重儿 ,易出现糖代谢紊乱。由于个体差异大 ,新生儿的正常血糖值尚无统一标准。出生时母亲供给胎儿的葡萄糖被突然中断 ,初生新生儿实际葡萄糖浓度依赖于分娩时间、方式和输液的种类〔1〕。Ｃｏｒｎｂｌａｔｈ和Ｒｏｉｓｎｅｒ认为生后 3ｄ内血糖低于 2 2ｍｍｏｌ/Ｌ(4 0ｍｇ/ｄｌ)及高于 7ｍ…     

新生儿垂体柄中断综合征1例

<正>患儿,男,40 d,因反复低血糖发作伴抽搐1月余入院。患儿系第5胎第1产,孕40+5周,因母亲患妊娠期高血压行剖宫产出生,出生体重3.45 kg,身长50 cm,无缺氧窒息史。生后13 h出现呛咳、全身发绀、呼吸困难、反应差,即于外院住院治疗,血糖未能测出,予静脉推注葡萄糖后复测血糖波动于2.8～     

新生儿低血糖的相关危险因素分析

目的 探讨住院新生儿的低血糖发生率并分析低血糖发生的相关危险因素.方法 常规监测所有住院新生儿的血糖水平,对高危新生儿和初次检测呈异常血糖水平者每天监测血糖,直至血糖水平恢复正常并稳定.结果 668例住院新生儿中检出低血糖113例,发病率为16.9%.低血糖在早产儿、足月儿和过期产儿的发生率分别为55.6%(19/34)、14.9%(93/625)和11.1%(1/9);在极低出生体质量儿、低出生体质量儿、正常出生体质量儿及巨大儿的发生率分别为77.8%(7/9)、51.1%(23/45)、12.4%(72/581)和33.3%(11/33);在重度窒息儿、轻度窒息儿和无窒息儿的发生率分别为42.9%(9/21)、34.3%(23/67)和14.0%(81/580);低血糖的发生还与母亲分娩时补液与否有关(9/51,58/180).结论 早产、低出生体质量、围产期窒息等新生儿易发生低血糖,应在新生儿早期主动连续监测新生儿尤其是高危儿的血糖水平,母亲分娩时应予以适当补液,同时注重早期喂养,以期及时诊治新生儿低血糖,减少其对新生儿的危害.     

妊娠期肝内胆汁淤积症孕妇分娩的新生儿入住NICU的影响因素分析

背景：妊娠期肝内胆汁淤积症（ICP）可能导致新生儿不良结局。 目的：探讨ICP孕妇分娩的新生儿生后24 h内入住新生儿重症监护室（NICU）的危险因素。设计：单中心病例对照研究。 方法：纳入2015年1月至2019年12月在重庆市永川区妇幼保健院娩出、母亲明确诊断ICP且本次为单胎妊娠的新生儿,根据其生后24 h内是否入住NICU分为住院组和非住院组,样本量计算显示每组至少需要131例新生儿。截取母亲孕期及分娩时资料、新生儿资料以及生后24 h内入住NICU情况和原因。采用二元Logistic回归分析影响ICP孕妇分娩的新生儿入住NICU的独立危险因素,构建ROC曲线评估这些危险因素对新生儿入住NICU的预测价值。 主要结局指标：ICP孕妇分娩的新生儿NICU住院的影响因素及预测因素。 结果：ICP孕妇娩出的新生儿621例,平均胎龄38.3(37.0,39.3)周,平均出生体重3 148±461)g,男308例。生后24 h内入住NICU（住院组）133例（21.4%）,主要原因包括早产（78例）、呼吸窘迫（20例）,低血糖、反应差和感染等;非住院组488例。住院组胎龄、出生体重、5 min Apgar评分、母亲诊断ICP的孕周均小于或低于非住院组,母亲分娩前最后1次ALT、AST、胆汁酸水平和新生儿早产率均高于非住院组,差异均有统计学意义。新生儿均随访至生后28 d,死亡1例（0.16%）。二元Logistic回归分析显示,胎龄小（OR=0.378,95%CI：0.301~0.474,P<0.001）,母亲孕期皮肤瘙痒（OR=2.410,95%CI：1.411~4.114,P=0.001）、胆汁酸水平高（OR=1.016,95%CI：1.003~1.028),P=0.012）和母亲产前BMI低（OR=0.930,95%CI：0.873~0.990,P=0.023）是新生儿生后需要NICU住院治疗的危险因素.ICP孕妇分娩的新生儿生后24 h内入住NICU的预测因素及性能：ICP母亲伴孕期皮肤瘙痒症状时,新生儿胎龄（最佳诊断界值≤36.6周）、母亲胆汁酸水平（最佳诊断界值＞20 μmol·L-1）和产前BMI（ 最佳诊断界值≤24 kg·m-2）联合诊断的敏感度达96.7%(95%CI：90.8%~99.3%）;ICP母亲不伴孕期皮肤瘙痒症状时,新生儿胎龄（最佳诊断界值≤36.5周）、母亲胆汁酸（最佳诊断界值＞26.8 μmol·L-1）和产前BMI（最佳诊断界值＞24 kg·m-2）联合诊断的敏感度达78.0%（95%CI：62.4%~82.4%）。 结论：胎龄小、母亲孕期皮肤瘙痒、孕期胆汁酸水平高和孕前BMI低是ICP母亲分娩的新生儿生后需要NICU住院治疗的危险因素。ICP孕妇伴孕期皮肤瘙痒症状时,胎龄≤36.6周、母亲孕期胆汁酸水平＞20 μmol·L-1和产前BMI≤24 kg·m-2联合预测新生儿NICU住院治疗的敏感度达96.7%。     

母亲产时发热伴新生儿感染的危险因素分析

目的探讨母亲产时发热伴新生儿感染的危险因素。方法病例对照研究。纳入2016年1月1日至12月31日在复旦大学附属妇产科医院（我院）产科建卡、母亲产时发热（体温峰值≥38℃）、胎龄≥37周、单胎的新生儿,根据我院新生儿感染的诊断标准［生后12~24 h血常规WBC≥50×109·L-1和（或）CRP≥20 mg·L-1,或生后24~48 h WBC≥30×109·L-1和（或）CRP≥8 mg·L-1）］分为感染组和对照组,从新生儿性别,胎龄,出生体重,分娩方式,母亲体温峰值,产前血WBC数和CRP,是否硬膜外麻醉,是否合并其他感染高危因素［B族链球菌（GBS）阳性、羊水Ⅲ°或羊水异味、胎膜早破≥18 h］,分析产时发热母亲新生儿感染的可能危险因素。结果323例新生儿进入分析,感染组123例,对照组200例。Logistic多因素回归分析显示,母亲体温>38.8℃（OR=11.89,95%CI：3.21~67.12)、产前血WBC>13.1×109·L-1（OR=6.50, 95%CI：1.87~78.25)、GBS阳性（OR=7.91 ,95%CI：1.77~22.13）,羊水Ⅲ°或羊水异味（OR=33.1,95%CI：3.34~101.56）和胎膜早破≥18 h（OR=15.12,95%CI：5.72~67.39）为母亲产时发热新生儿感染的独立危险因素。结论新生儿感染与母亲产前体温峰值、血WBC数相关。母亲产时发热且合并其他感染高危因素者,新生儿感染风险升高。硬膜外麻醉虽会引起母亲产时发热,但可能并不增加新生儿感染的风险。     

Glucose disappearance in infants of diabetic mothers. III. Relationship of spontaneous glucose disappearance to glucose tolerance,neonatal hypoglycemia and lowest blood glucose

Spontaneous glucose disappearance in the first 90 min of life and glucose disappearance following an intravenous injection of 1 g/kg dextrose were measured in 23 infants of insulin-dependent diabetic mothers. Spontaneous disappearance was log-linear in 12/23 infants, providing for calculation of an endogenous K_t which correlated significantly (P < 0.01) with the exogenous Kt determined after the dextrose injection, r = 0.74.Hypoglycemia <20 mg/dl occurred in 4/23 infants, and was identified during the spontaneous glucose disappearance (3 infants) and/or predicted by an endogenous K_t > 3.0%/min (2 infants). There was also a significant inverse correlation (P < 0.01) of the lowest blood glucose obtained within the first 24 h of life with the endogenous K_t, r = 0.61. There was no correlation of the endogenous or exogenous Kt, lowest blood glucose or hypoglycemia with White's classification of the maternal diabetes, diabetic control during pregnancy, the maternal blood glucose at delivery or the cord blood glucose.These data indicate that determination of spontaneous glucose disappearance within the first 90 min of life is useful in identifying infants of diabetic mothers with hypoglycemia or those who will subsequently develop hypoglycemia.     

Leitlinie zur Betreuung von Neugeborenen diabetischer M��tter

All diabetic women are advised to give birth in a hospital with a pediatric service that allows for continuous intravenous glucose administration, precluding the need for out-of-house transfer of the infant. Women with pre-pregnancy diabetes or on insulin treatment during pregnancy should give birth in a hospital offering round-the-clock neonatal care. Early (breast) feeding is of paramount importance and should be started 30?min after birth, subsequently every 2?C3?h. A mandatory preprandial blood glucose measurement should be taken 2?C3?h after birth and again immediately before the infant is transferred out of the delivery room; subsequent preprandial measurements at 6, 12, and possibly 24?h of age. In the event of three consecutive values of >2.5?mmol/l (45?mg/dl), further controls may be dispensed with. Simultaneously, infants should be checked for symptoms of hypoglycemia by a midwife or nurse on the maternity unit. Clinical findings suspicious for hypoglycemia should prompt immediate blood glucose determinations. Blood glucose concentrations below 2?mmol/l (36?mg/dl; in infants without symptoms) or 2.5?mmol/l (45?mg/dl; in infants with hypoglycemia-related symptoms, prior hypoglycemia, or following asphyxia) require immediate intervention in the form of feeding (preferably breast milk, otherwise hydrolyzed formula, or hydrolyzed starch solution only temporarily), by gavage if necessary. Intravenous glucose administration if blood glucose falls below 1.7?mmol/l (30?mg/dl). Routine echocardiography or laboratory tests (Ca2+, Mg2+, hematocrit, bilirubin) are not necessary unless otherwise indicated. Breast feeding should be consistently encouraged before and after delivery.     

Glucose disappearance in infants of diabetic mothers I. Relationship to maternal glucose tolerance and insulin production

Glucose disappearance and insulin response were determined in mother--infant pairs of normal, gestational diabetic and diabetic pregnancies following an intravenous glucose load. Mothers were studied in the third trimester of pregnancy and at least 6 wk postpartum. Significant differences were present in glucose disappearance and insulin response in both gestational diabetic and diabetic mothers during pregnancy compared with the control group. Infants were studied within 4 h of birth while fasting, and glucose and insulin levels followed through the first 3 days of life. Neonatal hypoglycemia did not occur and glucose disappearance (KT) was not different among the three groups. There was no correlation between maternal glucose tolerance or insulin production and that of their infants. The only distinguishing factor among the infants was higher insulin production in infants of diabetic mothers during the 60-min intravenous glucose tolerance test which persisted up to 4 h following the infusion. It is concluded that factors other than the degree of maternal glucose tolerance are responsible for the development of neonatal hypoglycemia in infants of diabetic mothers, most notably control of maternal diabetes, the amount of glucose infused immediately before delivery and neonatal glucose production.     

Maternal nutritional status, diabetes and risk of macrosomia among Native Canadian women

Multivariate methods were used to identify risk factors for macrosomia (birth weight >4000 g) among 741 singleton births to Native Canadian women from Sioux Lookout Zone, Ontario, Canada, in 1990–1993. The average birth weight was 3691±577 g, and 29.2% of infants weighed more than 4000 g at birth. Macrosomic infants were born at later gestational ages and were more likely to be male. Women delivering macrosomic infants were taller, entered pregnancy with higher body mass indexes (BMI) and gained more weight during pregnancy, but were less likely to smoke cigarettes. They were more likely to have previously delivered a macrosomic infant and to have had gestational diabetes mellitus (GDM). Risk of macrosomia was associated with maternal glycemic status; women with pre-existing diabetes were at greatest risk, followed by those with GDM A₂ (fasting glucose ≥6 mmol/l). Women with GDM A₁ (fasting glucose <6 mmol/l) were not at increased risk for delivering a macrosomic infant, but glucose-tolerant women with high glucose concentrations 1 h after the 50 g challenge were at somewhat increased risk. Maternal glycemic status and maternal nutritional status before and during pregnancy are important determinants of macrosomia in this native population.     

胎龄≤32周早产儿低血糖的危险因素分析

目的 探讨胎龄≤32周早产儿出生后发生低血糖的危险因素。方法 回顾性纳入2017年1月至2020年6月入住新生儿重症监护病房的86例胎龄≤32周低血糖早产儿作为低血糖组,随机选取同期住院监测血糖正常的早产儿172例为对照组。采用单因素分析与多因素logistic回归分析筛选早产儿低血糖的危险因素。结果 研究期间早产儿共计515例,其中低血糖86例（16.7%）。低血糖组小于胎龄儿（SGA）、剖宫产出生、孕母高血压、产前使用激素的比例均高于对照组（P < 0.05）,而出生体重及血糖检测前已静脉使用葡萄糖的比例均低于对照组（P < 0.05）。SGA（OR=4.311,95% CI：1.285~14.462）、孕母高血压（OR=2.469,95% CI：1.310~4.652）和产前使用激素（OR=6.337,95% CI：1.430~28.095）为早产儿低血糖的危险因素（P < 0.05）,静脉使用葡萄糖（OR=0.318,95% CI：0.171~0.591）为早产儿低血糖的保护因素（P < 0.05）。结论 SGA、孕母高血压和产前使用激素可增加胎龄≤32周早产儿早期发生低血糖的风险;对胎龄≤32周早产儿,建议生后尽早静脉使用葡萄糖,以减少低血糖的发生。     

Mild gestational diabetes in pregnancy and the adipoinsular axis in babies born to mothers in the ACHOIS randomised controlled trial

Background  

Mild gestational diabetes is a common complication of pregnancy, affecting up to 9% of pregnant women. Treatment of mild GDM is known to reduce adverse perinatal outcomes such as macrosomia and associated birth injuries, such as shoulder dystocia, bone fractures and nerve palsies. This study aimed to compare the plasma glucose concentrations and serum insulin, leptin and adiponectin in cord blood of babies of women (a) without gestational diabetes mellitus (GDM), (b) with mild GDM under routine care, or (c) mild GDM with treatment.     

Natural progress of blood glucose in full-term low-grade low-birthweight infants

BACKGROUND: Although various authors have suggested the risk of hypoglycemia in practical medicine for low-birthweight infants is exaggerated, convincing evidence using recent definitions of hypoglycemia is not documented. METHODS: To evaluate the risk of hypoglycemia in low grade low-birthweight infants (LGLBWI) (2100 g < birthweight < 2500 g) whose only abnormality is low-birthweight, whole blood glucose (BGw) was measured five times (0, 0.5, 1, and 4 h after birth and just before the first bottle feeding) in 49 LGLBWI and 38 normal birthweight infants. RESULTS: Whole blood glucose was not lower in LGLBWI with a gestational age of 38-40 weeks (GT38LGLBWI) than in normal birthweight individuals with a gestational age of 38-40 weeks at each of the five measuring times. No case of GT38LGLBWI, not even in small for gestational age infants, required treatment for hypoglycemia. The BGw was significantly lower in 37-week gestational age LGLBWI than in GT38LGLBWI at 0.5 h and 1 h after birth (P < 0.05). However, in all cases with low BGw value (below 30 mg/dL at 1 h after birth), BGw value increased naturally to the normal level 1.5 h after birth. No symptoms of hypoglycemia were observed. CONCLUSIONS: In the care of hypoglycemia in LGLBWI, attention should be paid first to gestational age, namely, tendency to prematurity. In this study, however, no hypoglycemia that required treatment was found among full-term normal LGLBWI, even those who were small for gestational age. Frequent blood glucose measurement for those infants is therefore unnecessary.     

Macrosomia,top of the iceberg: The charm of underlying factors

Background: Macrosomia is associated with childhood obesity. Gestational diabetes mellitus (GDM) is a risk factor for macrosomia. The aim of this large‐scale investigation was to determine the incidence, risk factors, characteristic features, and perinatal outcome of macrosomic infants. Methods: This prospective study was carried out on 6385 newborns. Demographic data included maternal age, paternal age, type of delivery, sex, parity and gestational age at delivery. Anthropometric measurements were recorded. ABO/Rh typing was performed and GDM was diagnosed. Results: Out of 6385 term deliveries, 477 infants (7.47%) were macrosomic. Incidence of GDM was 0.6% and 4.8% in the control group and in macrosomic births, respectively. Incidence of GDM(+) cases was 4% among macrosomic infants weighing 4000–4500 g. GDM(+) cases were densely populated (11%) in macrosomic infants weighing ≥ 4500 g (P≤ 0.05). Male/female ratio was significantly higher in macrosomic infants weighing ≥ 4500 g than those weighing 4000–4500 g (P≤ 0.05). High parental age was the risk factor for GDM. Blood group A was the most frequently observed type among mothers with macrosomic infants, however, blood group O was dominant in cases with GDM. In multivariate logistic regression analysis, the male infant was the most striking infant characteristic and GDM was the most striking maternal characteristic that were significantly associated with increased odds of macrosomic birth. Conclusions: This research reports the association between blood group system and macrosomia as well as parental age and GDM simultaneously. Our study reports a prevalence of GDM in both infants with normal birth weight and macrosomic newborns at the same time.