妊娠期糖尿病中巨大儿的危险因素及预后

目的 探讨妊娠期糖尿病中巨大儿发生的危险因素及其对母儿预后的影响.方法 收集2018年2月1日-2019年1月31日在郑州大学第三附属医院住院分娩的498例妊娠期糖尿病孕妇资料,以新生儿是否为巨大儿,分为巨大儿组(65例)和对照组(433例),行回顾性统计学分析.结果 巨大儿发生率13.1％ (65/498).经多因素...

Risk factors and prognosis analysis of macrosomia in patients with gestational diabetes mellitus

Objective To explore the risk factors of macrosomia in patients with gestational diabetes mellitus,and its effects on pregnancy outcome.Method A total of 498 women with gestational diabetes mellitus in The Third Affiliated Hospital of Zhengzhou University from February 1,2018 to January 31,2019 were enrolled and were divided into the macrosomia group(65 cases)and the control group(433 cases)according to the weight of newborns.The clinical data of the two groups were retrospectively reviewed.Result The prevalence of macrosomia was 13.1%(65/498).Multivariate Logistic regression analysis showed that fasting blood glucose(FPG)value in 75 g oral glucose tolerance test(OGTT),preconception body mass index and gestational weight gain were independent risk factors for macrosomia in patients with gestational diabetes mellitus(P<0.05).Compared with the control group,there were no significant differences between two groups as in maternal age,residence,assisted reproductive technology,gestational week of delivery,parity,family history of diabetes,history of macrosomia and insulin injection treatment(P>0.05).ROC curve analysis revealed that in pregnant women with gestational diabetes mellitus,the AUC of FPG in 75 g OGTT,preconception BMI and gestational weight gain in predicting macrosomia was 0.699,0.632,0.675,respectively,and the AUC of the combined prediction of macrosomia was 0.786.The cut-off value of each indicator in predicting macrosomia was 5.185 mmol/L,23.02 kg/m²,13.75 kg,respectively.In terms of pregnancy complications,the incidence of postpartum hemorrhage in the macrosomia group was significantly higher than that in the control group(P<0.05).There was no significant difference in neonatal outcomes between the two groups(P>0.05).Conclusion(1)Among pregnant women with gestational diabetes mellitus,FPG in 75 g OGTT,preconception BMI and gestational weight gain were independent risk factors for macrosomia;(2)When FPG in 75 g OGTT>5.185 mmol/L,preconception BMI>23.02 kg/m2 or gestational weight gain>13.75 kg,the risk of macrosomia was significantly increased in gestational diabetes mellitus population;(3)Macrosomia increase the risk of postpartum hemorrhage in pregnant women with gestational diabetes.