新生儿性别对妊娠期糖尿病人群妊娠结局的影响

目的:探讨在妊娠期糖尿病(GDM)人群中,新生儿性别与母婴妊娠结局的关系。方法:选择2014年7月1日至2017年12月31日期间,在昆明医科大学第一附属医院定期产检分娩的13599例单胎且病例资料完整者,应用国际糖尿病与妊娠研究组2010年发布的GDM诊断标准,对确诊的GDM患者按新生儿性别分组,比较分析两组人口统计学特征和母婴妊娠结局及妊娠期合并症情况。结果:GDM共3442例,发生率18.05%。男性新生儿1845例,女性新生儿1597例。2组间人口统计学如母亲年龄、身高、各孕期体质量、体质量指数(BMI)、孕期增重、瘢痕子宫、糖尿病家族史比较,差异无统计学意义(P>0.05)。母亲妊娠期合并症与妊娠结局2组间差异无统计学意义。新生儿出生体质量(3181.97±564.65gvs3099.17±523.85g,P<0.001)、身长(49.49±3.03cmvs49.06±2.63cm,P<0.001)、巨大儿发生率(5.0%vs2.4%,P<0.001)、新生儿需治疗率(15.6%vs11.5%,P<0.001)、需使用抗生素率(16.3%vs13.4%,P=0.019)、转新生儿重症监护室率(22.0%vs18.9%,P=0.025)、黄疸需治疗率(13.0%vs10.6%,P=0.033)男性新生儿组均高于女性新生儿组。结论:即使给予GDM患者良好的孕期保健及生活方式干预,其生育的男性新生儿的结局仍差于女性新生儿,应加强对GDM母亲所生育男性新生儿的干预。

The Relationship between Fetal Genders and Maternal-fetal Pregnancy Outcomes in Gestational Diabetes Mellitus

Objective:To investigate of the relationship between different fetal sex and maternal-fetus outcomes in gestational diabetes mellitus(GDM).Methods:We enrolled 13599 patients diagnosed with monocyesis in the first affiliated hospital of Kunming Medical University from July 1,2014 to June 31,2017.The diagnoses of GDM was according to the criteria of The International Association of Diabetes and Pregnancy Study Groups(IADPSG)2010.We compare the maternal demographic characteristics,maternal-fetal outcomes and pregnancy complications between different fetal gender groups.Results:2455 patients were diagnosed as GDM,and the incidence was 18.05%.There was no statistical difference in maternal demography with respect to age,height,weight in different trimesters,BMI,gestational weight gain scar uterus,and family history of diabetes between two groups.There was no statistical difference in maternal pregnancy outcomes and complications between the two groups.It demonstrated some significant differences between male and female in aspects of fetus neonatal birth weight(3181.97±564.65 g vs 3099.17±523.85 g,P<0.001),body length(49.49±3.03 cm vs 49.06±2.63 cm,P<0.001),the incidence of macrosomia(5.0%vs 2.4%,P<0.001),the rate of neonates needing treatment(15.6%vs 11.5%,P<0.001),the rate of antibiotic treatment(16.3%vs 13.4%,P=0.019),the rate of neonatal intensive care unit stay(22.0%vs 18.9%,P=0.025),the rate of jaundice needing treatment(13.0%vs 10.6%,P=0.033).Conclusions:The outcomes of male newborns wereworse than those of female newborns'in GDM patients under good prenatal care and lifestyle intervention.Therefore,male neonates who were born by GDMs should be given more care.