Time-specific placental growth factor (PlGF) across pregnancy and infant birth weight in women with preexisting diabetes

Objective: Determine the independent association between time-specific placental growth factor (PIGF)—a marker of placental vasculature—and infant birth weight in offspring of mothers with preexisting type 1 and 2 diabetes. Methods: A total of 150 women were recruited from Joslin Diabetes Center’s/Beth Israel Deaconess Medical Center’s Diabetes in Pregnancy Program. PlGF was measured up to four times during pregnancy. Infant birth weight and covariate data were collected from medical records. Hemoglobin A1c was assessed from drawn blood samples. We used generalized linear and log-binomial models to calculate the change in continuous birth weight, as well as macrosomia for every unit change in time-specific ln-transformed PlGF, respectively. Models were adjusted for potential confounders. Results: Approximately 75% of women had type 1 diabetes. Third trimester PlGF levels were significantly associated with infant birth weight (r = 0.24, p = 0.02 at 27–34 weeks; r = 0.26, p < 0.009 for 36–40 weeks). After full adjustment, there was a 6.1% and 6.6% increase in birth weight for gestational age percentile for each unit increase in ln-transformed PlGF level at 27–34 weeks and 35–40 weeks, respectively (95% CI for 27–34 weeks gestation: 1.1, 11.0, and 95% CI for 35–40 weeks gestation: 0.7%, 12.5%). We found a statistically significant increased risk of macrosomia among women with higher ln-transformed PlGF levels (RR: 1.72; 95% CI: 1.09, 2.70). Associations were not mediated by hemoglobin A1c. Conclusions: Third trimester PlGF levels were associated with higher birth weight in women with preexisting diabetes. These findings may provide insight to the pathophysiology of fetal overgrowth in women with diabetes.     

医学营养治疗对糖代谢异常妊娠期患者增重及新生儿出生体重的影响

目的 探讨医学营养治疗（MNT）对糖代谢异常妊娠期患者增重及新生儿出生体重的影响。方法 2005年5月至2005年10月对北京妇产医院诊断为糖代谢异常的单胎孕妇106例在产科营养门诊接受医学营养治疗，在进行总热量控制的基础上，使用等食品交换份结合血糖生成指数的方法，把同期未接受该方法而采用传统营养治疗方法的糖代谢异常孕妇96例作为对照组，比较两组孕妇的体重增长、体重指数（BMI）的增长及新生儿体重增长情况。结果 两组巨大儿的发生率分别为8．49％、13．54％，研究组巨大儿的发生率有所下降；两组比较孕妇妊娠期体重增长、每周体重增长、BMI增加、每周BMI增加差异均有显著性；新生儿体重有所下降，但差异无显著性。结论 对妊娠糖代谢异常患者进行科学、合理的营养治疗，妊娠期体重增加明显减少，新生儿体重在合适范围，对孕妇妊娠期体重增长的管理有提示作用。     

Birthweight in women with potential gestational diabetes mellitus--an effect of obesity rather than glucose intolerance?

BACKGROUND: The purpose was to compare the influence of varying levels of glycemia on the perinatal outcome. METHODS: The data charts of 383 women screened for gestational diabetes mellitus with an oral glucose tolerance test during two birthyears were retrospectively evaluated. In 55 women gestational diabetes mellitus was diagnosed and treated with diet. The non-diabetic women (n=328) were subdivided into a borderline diabetes group (n=74) and a normal group (n= 254) on the basis of the oral glucose tolerance test result. The birth registry of 8196 singleton pregnancies from The Perinatal Research Unit at Skejby University Hospital served as the background population. RESULTS: Birthweight was highest in the borderline group. Weight increase during pregnancy was larger in the non-diabetic than the gestational diabetic women (15 vs. 8 kg p<0.01). The women with less increase of body weight delivered neonates with lower birthweight than those with higher increase. Birthweight was associated with maternal weight during pregnancy (p<0.01). Birthweight ratio increased with increasing glucose intolerance. Vaginal delivery rate was less and cesarean section rate higher in women with gestational diabetes mellitus compared to the non-diabetic women. No significant difference was found in the incidence of hypertensive disorders during pregnancy or neonatal morbidity. CONCLUSIONS: Even minor hyperglycemia is associated with increasing birthweight. Birthweight is reduced in GDM when dietary treatment is instituted and effect on weight gain is achieved.     

The association between maternal obesity, glucose intolerance and hypertensive disorders of pregnancy in nondiabetic pregnant women.

OBJECTIVE: The aim of this study is to evaluate whether pregnancy-induced hypertension (PIH) among nondiabetic patients is associated with glucose intolerance. MATERIALS AND METHODS: A retrospective case-control study was designed including a study group who had pregnancy-induced hypertension or preeclampsia. Patients with normal pregnancy were used as a control group matched to cases by parity. Diabetic patients, nonsingleton pregnancies, and women without prenatal care were excluded. Data concerning fasting glucose levels, glucose challenge test (GCT), and oral glucose tolerance test (OGTT) were collected from patients' files. RESULTS: There were 131 patients in each study group. The study group had significantly higher mean maternal age, mean GCT levels, and mean pregestational body mass index (BMI) (28.0 +/- 5.8 vs. 26.5 +/- 5.3, p = 0.02; 5.8 +/- 1.4 vs. 5.1 +/- 1.1 p = 0.0018; 26 +/- 5.1 vs. 23 +/- 4.0 p < 0.001, respectively) than the control group. Mean gestational age and birthweight were also significantly lower in the study group (38.5 +/- 2.1 vs. 39.4 +/- 1.7 p < 0.001; 2929 g +/- 614.7 vs. 3225 +/- 461.1 p < 0.001, respectively). Stratified analysis according to parity demonstrated that pregestational BMI, weight gain during pregnancy, and cesarean section (CS) were significantly higher in women with pregnancy-induced hypertension than in controls in all parity groups. Maternal age and mean GCT levels of women with pregnancy-induced hypertension were higher in all parity groups but statistically significant only among multiparous patients. Multiple logistic regression demonstrated that BMI, weight gain, and maternal age were independently associated with pregnancy-induced hypertension, while GCT level was not. Conclusions. Elevated pregestational BMI is an independent risk factor for development of pregnancy-induced hypertension (PIH). Its association with elevated GCT levels implies that even without overt diabetes, glucose intolerance may play a role in the pathogenesis of preeclampsia in obese patients.     

糖耐量异常的晚期妊娠妇女胰岛素分泌与胰岛素抵抗的研究

OBJECTIVE: To investigate whether insulin secretion and resistance are different in glucose tolerant and intolerant women with normal pre-pregnant body mass index (BMI) during late pregnancy and to find out if there is association between gestational diabetes and insulin resistance syndrome. METHODS: On the basis of a 4-hour oral glucose tolerance test (OGTT), 32 gestational diabetes mellitus (GDM) patients, 21 gestational impaired glucose tolerant (GIGT) patients, and 50 normal glucose tolerant (NGT) cases were selected from uncomplicated pregnant women. Those had normal pre-pregnant BMI who had a 1-hour 50-g glucose-screening test (> or = 7.2 mmol/L), performed between 24-28 weeks of gestation. During the OGTT, several indexes of insulin resistance, insulin secretion, lipid metabolism were measured in addition to the standard glucose measurements. RESULTS: Glucose area under curve (GAUC), insulin area under curve (IAUC), insulin sensitivity index (ISI) transformed to natural logarithm and triglycerides (TG) are all significantly higher (P < 0.05) in GDM women. The means of these indexes in GDM group are 26.3 mmol/L.h-1, 276.5 mU/L.h-1, 4.2 and 3.2 mmol/L, respeetively. On the other hand, however, the differences of these indexes (except TG) between GIGT and NGT women are not statistically significant. The ratio of IAUC/GAUC has an increasing trend from GDM group, GIGT group to NGT group (10.5, 11.4 and 11.7, respectively), but the difference is not statistically significant. Multiple correlation coefficient study demonstrated that ISI is significantly positively correlated with GAUC, IAUC and TG (P < 0.01). CONCLUSIONS: Compared with NGT women, GDM women has impaired insulin secretion, abnormally increased insulin resistance, and relatively dyslipidemia. GDM seems to be a component of the syndrome of insulin resistance that provides an excellent model for study and prevention in a relatively young aged group.     

Evaluation of the diagnostic criteria of gestational diabetes mellitus in Japan: a study of women with mild glucose intolerance during late pregnancy

To evaluate the validity of the diagnostic criteria of gestational diabetes (GDM) recommended by the Japan Society of Obstetrics and Gynecology (JSOG), we investigated women with mild glucose intolerance during pregnancy, using the borderline criteria of the Japan Diabetes Society (JDS), cut-off values of which are lower than those of the JSOG criteria. Five hundred seventy one pregnant women were screened for GDM after 20 weeks' gestation using a 50g glucose challenge test. Only ten women (1.8% of total), who fulfilled the JSOG criteria, were found (GDM group). At the same time, eighteen women (3.2% of total), who did not fulfill the JSOG criteria but who met two or more abnormal values of the JDS borderline criteria, were also found (A2 group). There was no significant difference between the two groups in either mean maternal age or the percentage of women over 30 years of age. delta IRI/delta BS in a 75g glucose tolerance test in the A2 group was 0.58 (median), which was similar to that in the GDM group (0.42). This result, however, was significantly lower than that in both the normal control group (1.00, p less than 0.01) and the group of women with only one abnormal value among the JDS criteria (A1 group, 0.88, less than 0.01). Before therapy, there was no significant difference in the diurnal plasma glucose level between the GDM group, who could be treated with diet therapy, and the A2 group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Maternal weight gain in women with good pregnancy outcome

The most liberal published guidelines for maternal weight gain at term suggest a range of 9-14 kg. In a cohort of 4674 women with good pregnancy outcomes who delivered at the University of California, San Francisco between 1980-1988, the lower end of the currently published weight gain range was relevant, but the upper limit of weight gain was higher. Good pregnancy outcome was defined as a vaginal birth between 37-42 weeks' gestation of a living, singleton infant of appropriate birth weight for gestational age without congenital anomalies, born to a mother who did not experience diabetes or hypertension during pregnancy. Ranges of 12-18 and 10-21 kg described 50 and 80% of the group, respectively. Mean weight gain was associated with maternal pre-pregnancy body mass, parity, and race, with the largest differences observed in overweight and obese women. The results reported here suggest that a wider range of maternal weight gain than is currently recommended is associated with good pregnancy outcome.     

Risk factors for postpartum glucose intolerance in women with gestational diabetes mellitus

Objectives: To determine the risk factors for glucose intolerance (GI) during the postpartum period in women with gestational diabetes mellitus (GDM).

Methods: This prospective cohort study included 72 Japanese women with GDM who underwent 75?g oral glucose tolerance tests (OGTT) at 12 weeks after delivery. These women were divided into the GI group and the normal group based on postpartum OGTT. Risk factors for GI, including levels of blood glucose (BG), area under the curve (AUC) of glucose, AUC insulin, HbA1c, homeostasis model assessment-insulin resistance (HOMA-IR), HOMA-β, insulinogenic index (II) and the oral disposition index (DI) in antepartum OGTT, were analyzed by logistic regression analyses.

Results: Of the 72 women, 60 (83.3%) were normal and 12 (16.7%) had GI. By univariate logistic regression analyses, fasting BG, AUC glucose, HOMA-β, II and oral DI were selected as risk factors for GI. Multivariate logistic regression analysis revealed that the level of II in antepartum OGTT was a significant factor that predicted GI after delivery (odds ratio, 0.008; 95% CI, 0.0001–0.9; p?Conclusions: II measured by OGTT during pregnancy might be a useful predictor of GI within the early postpartum period in women with GDM.     

Maternal smoking, birth weight, infant death, and the self-selection problem.

Several aspects of the relationship between maternal smoking and birth weights of infants are discussed. No satisfactory explanation for Yerushalmy's results has been given other than that low birth weight appears to relate more to the smoker than to the smoking. Recent studies by Silverman support this position. The possibility that nicotine may induce a physiologic response that serves to alleviate bioenergetic deficiency in some individuals should not be overlooked. In this view, both smoking and low birth weight are symptoms of deficient maternal bioenergetic systems.     

Protease inhibitors and decreased birth weight in HIV-infected pregnant women with impaired glucose tolerance.

OBJECTIVE: To assess the impact of highly active antiretroviral therapy, including a protease inhibitor (HAART/PI), on maternal glucose tolerance and fetal growth. STUDY DESIGN: A retrospective chart review of pregnancy outcomes of human immunodeficiency virus-infected pregnant women receiving HAART/PI (n=41) or zidovudine monotherapy (n=23). RESULTS: Abnormal 1-hour glucose tolerance tests (1hGTT) were observed in 30% of subjects receiving HAART/PI between 24 and 28 weeks' gestation. An elevated 1hGTT was associated with a significantly lower mean birth weight in subjects receiving HAART/PI compared to babies born to mothers with a normal 1hGTT (3.40+/-0.09 vs 3.00+/-0.18 kg, p<0.05, ANOVA). CONCLUSION: HAART/PI therapy is associated with an increased rate of impaired glucose tolerance in pregnancy and impaired fetal growth. This finding merits further investigation.     

Influence of rest during pregnancy on birth weight in working women

OBJECTIVE: Birth weight in Sweden has increased during the past decades. We investigated whether rest provided by the combination of time off from work and social benefits among working pregnant women contributed to the observed changes. METHOD: A total of 7,459 consecutively delivered women in 1978, 1986, 1992, and 1997 at 2 delivery wards in southeastern Sweden were studied. RESULTS: Between 1978 and 1997, the average birth weight among the children of the women studied increased from 3,484 to 3,566 grams (P < .001). The in-crease in weight was most evident among infants born to women who were employed during pregnancy. The use of social benefits and increased rest during pregnancy did not significantly influence birth weight (P = .107), even after adjustment for gestational length, parity, smoking, age, and occupation. CONCLUSION: The continuous increase in infants' birth weight among pregnant women in this study did not correlate with rest periods in the form of leave supported by social benefit programs. The effects of social benefit programs on pregnancy outcome may thus be overrated and merits further research.     

Effects of new criteria for type 2 diabetes on the rate of postpartum glucose intolerance in women with gestational diabetes.

OBJECTIVE: Our purpose was to determine the impact of the 1997 American Diabetes Association diagnostic criteria for type 2 diabetes mellitus on the rate of postpartum glucose intolerance in women with gestational diabetes. STUDY DESIGN: Women identified as having gestational diabetes were instructed to undergo a 75-g, 2-hour glucose tolerance test 4 to 6 weeks after delivery. The results were retrospectively categorized with both the 1979 National Diabetes Data Group criteria and those recommended by the American Diabetes Association in 1997. RESULTS: Though the rate of overt diabetes mellitus did not increase when the 1997 American Diabetes Association criteria were used (7.8% vs 5.6%, P = not significant), the rate of impaired glucose metabolism was higher (20.1% vs 5%, P <.001). Most women (28/30, 93%) with a nondiagnostic glucose tolerance test result by the older criteria had abnormal results by the newer criteria. Fifty women had abnormalities of glucose metabolism under 1997 American Diabetes Association criteria; 34% of these women had fasting plasma glucose values in the normal range. Of the 25 women with impaired glucose tolerance, 16 (64%) had only an abnormal 2-hour value, with normal fasting glucose values. CONCLUSIONS: The rate of postpartum abnormalities in glucose metabolism more than doubles when the 1997 American Diabetes Association criteria are applied; more women are identified with lesser degrees of impairment. However, relying on fasting glucose levels alone, without glucose tolerance testing, may miss one third of women with such abnormalities.     

The effect of maternal obesity on pregnancy outcomes in women with gestational diabetes

Objective.?To examine the impact of maternal obesity on maternal and neonatal outcomes in pregnancies complicated with gestational diabetes mellitus (GDM).

Methods.?Women with singleton pregnancies and GDM enrolled in an outpatient GDM education, surveillance and management program were identified. Maternal and neonatal pregnancy outcomes were compared for obese (pre-pregnancy BMI?≥?30?kg/m²) and non-obese (pre-pregnancy BMI?<?30?kg/m²) women and for women across five increasing pre-pregnancy BMI categories.

Results.?A total of 3798 patients were identified. Maternal obesity was significantly associated with the need for oral hypoglycemic agents or insulin, development of pregnancy-related hypertension, interventional delivery, and cesarean delivery. Adverse neonatal outcomes were also significantly increased including stillbirth, macrosomia, shoulder dystocia, need for NICU admission, hypoglycemia, and jaundice. When looking across five increasing BMI categories, increasing BMI was significantly associated with the same adverse maternal and neonatal outcomes.

Conclusion.?In women with GDM, increasing maternal BMI is significantly associated with worse maternal and neonatal outcomes.     

Impact of hypertensive disorders of pregnancy at term on infant birth weight

This study was performed to investigate the impact of hypertensive disorders of pregnancy at term on neonatal birth weight. All singleton live births delivered between 37 and 42 weeks of gestation complicated by hypertensive disorders over a 7-year period (n = 362) was compared to 34 783 uncomplicated singleton deliveries in the same period. The individualized gestation-related optimal weight (GROW) was calculated for each individual case adjusted for the effects of maternal booking weight, height, parity, gestation at delivery, and fetal sex. Small-for-gestational-age (SGA) was defined as a birth weight less than the 10th percentile of the GROW. The incidence of SGA babies was significantly higher in subjects with preeclampsia and eclampsia than in control subjects (24.6 versus 11.3%; odds ratio = 2.55; 95% CI: 1.84, 3.55). Preeclampsia significantly reduced fetal birth weight by 130 g or 4.3%. Those with eclampsia on average had a neonatal birth weight 349 g or 11.0% below that of the GROW. In contrast, there was no significant difference in the incidence of SGA babies or degree of deviation from GROW between those with or without gestational hypertension.     

Maternal and umbilical resistin levels do not correlate with infant birth weight either in normal pregnancies and or in pregnancies complicated with gestational diabetes

Objective.?To evaluate the role of resistin in the pathophysiology of insulin resistance during pregnancy and on the birth weight of infants born from women with gestational diabetes (GDM).

Material and methods.?Thirty women diagnosed with GDM were compared to 30 normal pregnant controls. Maternal serum resistin and insulin levels were measured at the time of the oral glucose tolerance test screening. In addition, umbilical levels of resistin and insulin were measured at the time of delivery.

Results.?There was no difference in maternal serum resistin levels in women with GDM as compared to normal controls at 24–26 weeks. There was no difference in umbilical resistin levels between the infants born in the two groups. There was no correlation between infant weight and either maternal resistin at 24–26 week or umbilical resistin levels.

Conclusion.?There were no significant differences in umbilical resistin levels between infants born of women with GDM as compared to normal pregnant women. In addition, there was no correlation between resistin levels during pregnancy, as well as between umbilical resistin levels and neonatal birth weight. In conclusion, resistin seems to play a rather minor role in the pathophysiology of GDM and the energy metabolism during fetal life.     

Fears associated with pregnancy and childbirth--experiences of women who have recently given birth

OBJECTIVE: To describe fears associated with pregnancy and childbirth and to see whether women who have recently given birth feel that their fears were justified. DESIGN: A qualitative study. Data were collected by semi-structured interviews. Data interpretation was based on the method of content analysis. SETTING: The maternity units of two university hospitals in Finland. PARTICIPANTS: A convenience sample of 20 women, 10 primiparae and 10 multiparae. The interviews were held 2 or 3 days after childbirth. FINDINGS: The most common fears associated with pregnancy and childbirth were concerned with the baby's well-being, the course of pregnancy, and childbirth. The fears found expression in different kinds of behaviours, emotions and physical sensations. Many of the participants felt that their fears had not been justified, but some maintained that their fears had been justifiable. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: There was much inter-individual variation in the fears associated with pregnancy and childbirth. It is important that diagnosis during pregnancy is undertaken sensitively and that midwifery staff remember that pregnant women may have very serious fears associated with pregnancy and childbirth. The participants in this study felt that fears associated with pregnancy and childbirth also had positive meanings. It may not be essential to try to protect women against these fears or to remove them altogether, but to give every pregnant women the opportunity to deal with her own fears and to obtain the help she needs in her situation.     

Maternal and paternal family history of diabetes in women with gestational diabetes or insulin-dependent diabetes mellitus type I

Animal studies have shown that prenatal exposure to a diabetic intrauterine milieu leads to an increased risk in the female offspring of developing gestational diabetes (GD). In the present study, the family history of non-insulin-dependent diabetes mellitus type II (NIDDM) and insulin-dependent diabetes mellitus type I (IDDM) was evaluated in 106 women with GD, as compared to 189 women with IDDM. In GD patients, the prevalence of diabetes was significantly greater in mothers than in fathers (p = 0.03). This was mainly due to a greater prevalence of NIDDM in the mothers (p = 0.05). Furthermore, a significant aggregation of NIDDM was also observed in the maternal-grandmaternal line of GD women, as compared to the paternal-grandpaternal side (p = 0.02). In patients with IDDM no significant difference concerning the prevalence of any type of diabetes between mothers and fathers was observed. In conclusion, an aggregation of NIDDM in mothers and grandmothers of women with GD is reported here. A history of NIDDM on the maternal side of pregnant women should be considered as a particular risk factor for GD and, hence, for intergenerative transmission of NIDDM, which therefore might be prevented, at least in part, by strict avoidance of GD.     

糖代谢异常孕妇体质量及相关因素对新生儿出生体质量的影响

目的 探讨影响糖代谢异常孕妇新生儿出生体质量的相关因素.方法 选择2005年1月-2009年12月在北京大学第一医院分娩的临床资料齐全的妊娠合并糖代谢异常足月单胎孕妇1157例,根据孕前体质指数(BMI)分成4组:53例BMI＜18.5 kg/m2为低体质量组,647例BMI18.5～23.9 kg/m2为理想体质量组,323例BMI 24.0～27.9 kg/m2为超体质量组,134例BMI≥28.0 kg/m2为肥胖组.1157例新生儿按出生体质量分为:出生体质量2500～4000 g为正常体质量儿(987例),其中545例出生体质量3000～3500 g为适宜体质量儿;出生体质量≥4000 g为巨大儿(112例);出生体质量＜2500 g为低体质量儿(58例).记录其孕前体质量、身高、糖代谢异常诊断时间及诊断时体质量、孕期血脂水平、不良产史、糖尿病家族史、分娩孕周、分娩时体质量、新生儿出生体质量.分析孕前BMI、孕期体质量增长(分娩时体质量-孕前体质量)、诊断糖代谢异常的孕周、诊断后孕妇体质量增长(分娩时体质量-诊断糖代谢异常时体质量)、孕期血脂水平、不良产史及糖尿病家族史对新生儿出生体质量的影响及计算孕前不同BMI孕妇分娩适宜体质量儿的孕期体质量适宜增长范围.结果 (1)新生儿平均出生体质量:低体质量组为(3142±333)g,理想体质量组为(3339±476)g,超体质量组为(3381±581)g,肥胖组为(3368±644)g.新生儿出生体质量随孕前BMI增加而增加,低体质量组新生儿平均出生体质量低于其他3组,分别比较,差异均有统计学意义(P＜0.05);但理想体质量组、超体质量组、肥胖组间分别比较,差异均无统计学意义(P＞0.05).(2)分娩正常体质量儿和巨大儿孕妇的孕期体质量增长:分娩正常体质量儿及分娩巨大儿的各组孕妇孕期体质量增长为,理想体质量组分别为(13.5±4.5)及(17.1±5.4)kg,超体质量组分别为(11.6±4.9)及(15.3±6.4)kg,肥胖组分别为(10.3±5.0)及(14.7±7.4)kg,3组分别比较,差异均有统计学意义(P＜0.05);低体质量组分娩巨大儿的孕妇仅1例,无法进行统计学分析.(3)分娩正常体质量儿和巨大儿孕妇的糖代谢异常诊断孕周:理想体质量组分别为(27.8±5.8)及(29.8±5.3)周,超体质量组分别为(26.7±6.8)及(30.2±4.1)周,两者分别组内比较,差异均有统计学意义(P＜0.05);肥胖组分别为(26.2±7.5)及(25.7±9.3)周,差异无统计学意义(P＞0.01);低体质量组分娩巨大儿孕妇例数仅1例,无法进行统计学分析.(4)分娩正常体质量儿与巨大儿孕妇的血脂水平:分娩巨大儿孕妇血清甘油三酯水平[(3.1±1.5)mmol/L]明显高于分娩正常体质量儿的孕妇[(2.7±1.2)mmol/L,P＜0.01];分娩巨大儿孕妇血清高密度脂蛋白胆固醇水平[(1.4±0.3)mmol/L]明显低于分娩正常体质量儿的孕妇[(1.7±0.9)mmol/L,P＜0.05];分娩巨大儿孕妇血清低密度脂蛋白胆固醇及总胆固醇水平[分别为(2.8±0.8)及(5.4±1.1)mmol/L]均低于分娩正常体质量儿的孕妇[分别为(3.0±0.9)及(5.6±1.1)mmol/L],但差异无统计学意义(P＞0.05).(5)影响新生儿出生体质量的相关因素:将年龄、不良产史、糖尿病家族史、孕前BMI、孕期体质量增长、诊断糖代谢异常后孕妇体质量增长、孕期血脂水平、糖代谢异常分类、诊断孕周等因素进行logistic多元回归模型分析,最终进入回归模型的变量中排在前3位的是孕前BMI、孕期体质量增长及高密度脂蛋白胆固醇水平(P＜0.01).结论 妊娠合并糖代谢异常孕妇新生儿出生体质量与孕前BMI、孕期体质量增长、孕期血浆高密度脂蛋白胆固醇水平相关.