上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (12): 1750-.doi: 10.3969/j.issn.1674-8115.2011.12.020

• 论著（临床研究） • 上一篇    下一篇

糖代谢异常孕妇血糖水平与发生巨大儿的关系探讨

李华萍, 孙平平   

  1. 上海交通大学附属第六人民医院妇产科, 上海 200233
  • 出版日期:2011-12-28 发布日期:2012-01-04
  • 作者简介:李华萍（1965—）, 女, 副主任医师, 博士；电子信箱: hpli819@sohu.com。

Relationship between plasma glucose levels and macrosomia in women with abnormal glucose metabolism during pregnancy

LI Hua-ping, SUN Ping-ping   

  1. Department of Obstetrics and Gynecology, the Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China
  • Online:2011-12-28 Published:2012-01-04

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摘要：

目的 探讨妊娠期糖代谢异常孕妇葡萄糖耐量试验（OGTT）血糖水平与巨大儿发生的关系。方法 分析125例妊娠期糖尿病（GDM）孕妇和21例妊娠期糖耐量受损（GIGT）孕妇的临床资料，根据分娩情况分为巨大儿组（n=36）和非巨大儿组（n=110）。采用t检验、χ2检验和多因素Logistic回归分析妊娠期糖代谢异常孕妇OGTT血糖水平与巨大儿发生的关系。结果 ①两组孕妇空腹血糖（FPG）和OGTT 1 h血糖差异有统计学意义（P＜0.05），50 g葡萄糖筛查（GCT）值、OGTT 2 h血糖和OGTT 3 h血糖差异无统计学意义（P＞0.05）。②孕妇FPG＜5.3 mmol/L各水平级别相对危险度（OR值）均＜1，发生巨大儿风险较低；FPG≥5.3 mmol/L各水平级别OR值均＞1，为巨大儿发生的危险因素。③孕期随体质量增加，OR值增高；体质量增加越快，巨大儿发生的风险越高；FPG＞5.1 mmol/L，体质量增长＞16～18 kg的孕妇其巨大儿发生率明显升高。结论 妊娠期糖代谢异常孕妇FPG水平升高为发生巨大儿的主要危险因素，孕期血糖控制不佳可能导致巨大儿及相关并发症发生。

关键词: 葡萄糖耐量试验, 妊娠期糖尿病, 妊娠期糖耐量受损, 巨大儿

Abstract:

Objective To investigate the relationship between plasma glucose levels in oral glucose-tolerance test (OGTT) and macrosomia in women with abnormal glucose metabolism during pregnancy. Methods The clinical data of 125 pregnant women with gestational diabetes mellitus (GDM) and 21 women with gestational impaired glucose tolerance (GIGT) during pregnancy were retrospectively analysed. Macrosomia group (n=36) and nonmacrosomia group (n=110) were divided according to the delivery outcomes. T-test, chi-square test and multivariate Logistic regression analysis were employed to analyse the relationship between plasma glucose levels in OGTT and macrosomia in women with abnormal glucose metabolism during pregnancy. Results ①There were significant differences in fasting plasma glucose (FPG) and 1 h plasma glucose in OGTT between two groups (P＜0.05), while there was no significant difference in 50 g glucose challenge test (GCT) value, 2 h plasma glucose in OGTT and 3 h plasma glucose in OGTT between two groups (P＞0.05). ②Pregnant women with FPG＜5.3 mmol/L and odd ratios (OR) ＜1 had a lower risk for macrosomia, while those with FPG ≥5.3 mmol/L and OR ＞1 had a higher risk for macrosomia. ③OR increased with weight gain during pregnancy, and the risk for macrosomia increased with the weight gain. Pregnant women with FPG＞5.1 mmol/L and weight gain＞16-18 kg had a significant higher risk for macrosomia. Conclusion For women with abnormal glucose metabolism during pregnancy, high level of FPG is a major risk factor for macrosomia. Poor blood glucose control in pregnancy may lead to macrosomia and related complications.

Key words: oral glucose-tolerance test, gestational diabetes mellitus, gestational impaired glucose tolerance, macrosomia