妊娠期糖尿病孕妇分娩巨大儿的影响因素分析

目的:分析妊娠期糖尿病(GDM)孕妇分娩巨大儿的可能影响因素。方法:选取定期产检并分娩、孕周>37周的单活胎GDM孕妇371例临床资料,包括年龄、身高、体质量、孕前体质量指数(BMI)、孕期体质量增长、糖尿病家族史、不良孕产史、巨大儿产史、新生儿性别、血糖治疗方案、血糖控制情况、是否分娩巨大儿等。采用非条件多因素二分类logistic回归方程分析影响GDM孕妇分娩巨大儿的可能影响因素。结果:巨大儿组孕妇身高、体质量和新生儿男性人数均高于非巨大儿组(P<0.05～P<0.01),而巨大儿组孕妇血糖控制良好率明显低于非巨大儿组(P<0.01)。孕妇孕前后体质量指数差和血糖控制情况均是分娩巨大儿的独立影响因素(P<0.05)。结论:有效控制GDM孕妇孕期体质量的过度增长,维持良好的血糖水平,对于预防GDM孕妇分娩巨大儿具有潜在的意义。

The influence factors of the delivery of macrosomia in pregnant women with gestational diabitets mellitus

Objective:To analyze the influence factors of the delivery of macrosomia in pregnant women with gestational diabitets mellitus(GDM). Methods:The clinical data,which included the age,height,pre-pregnancy body mass index,increase of body mass, family history of diabetes, abnormal pregnancy history, neonatal sex, treatment programmes of blood sugar, blood sugar control and delivery of macrosomiain 371 GDM pregnant women with more than 37 weeks LSA were retrospectively analyzed. The influence factors of the incidence of macrosomia in pregnant women with GDM were analyzed using multi-factor logistic regression analysis. Results:The height and body mass of pregnant women and male newborns in macrosomia group were higher than those in nonmacrosomia group( P<0. 01 to P<0. 05),the good rate of blood sugar control in macrosomia group was significantly lower than that in nonmacrosomia group (P<0. 01). The analysis showed that the difference of body mass index between before and after pregnancy and blood sugar control were the independent influence factors of the delivery of macrosomia in pregnant women with GDM(P <0. 05). Conclusions:The effective controlling the excessive growth of body mass and maintaining the good blood sugar level in pregnant women with GDM can reduce the incidence of the delivery of macrosomia.