[1]忻荣荣,李冬梅,武晓玲,等.妊娠期糖尿病患者孕中晚期糖化血红蛋白与子代出生时及6周体重的相关性[J].国际内分泌代谢杂志,2024,44(03):172-176.[doi:10.3760/cma.j.cn121383-20221109-11032]
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妊娠期糖尿病患者孕中晚期糖化血红蛋白与子代出生时及6周体重的相关性()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
44
期数:
2024年03期
页码:
172-176
栏目:
论著
出版日期:
2024-05-20

文章信息/Info

Title:
Correlation between glycated hemoglobin in mid-to-late pregnancy and birth weight of offspring in gestational diabetes mellitus patients
作者:
忻荣荣1; 李冬梅2; 武晓玲1; 王立志1; 张红亮1
1陆军第八十一集团军医院干部病房科,张家口 075000; 2内蒙古自治区人民医院内分泌科,呼和浩特 010020
Author(s):
Xin Rongrong1; Li Dongmei2;  Wu Xiaoling1;  Wang Lizhi1;  Zhang Hongliang1.
1Department of Cadre Ward, The hospital of 81st Group Army PLA, Zhangjiakou 075000, China; 2Department of Endocrinology, Inner Mongolia People's hospital, Hohhot Inner Mongolia 010020, China
关键词:
妊娠期糖尿病;  糖化血红蛋白;  新生儿出生体重;  生长速度
Keywords:
Gestational diabetes;  Glycated hemoglobin;  Neonatal birth weight;  Growth rate
DOI:
10.3760/cma.j.cn121383-20221109-11032
摘要:
目的 探讨妊娠期糖尿病(GDM)孕妇孕中晚期平均糖化血红蛋白A1c(HbA1c)与子代出生时及6周体重的相关性。方法 收集内蒙古自治区人民医院556例GDM孕妇资料及子代6周的体重,GDM孕妇每4～6周化验HbA1c至分娩前,以孕中晚期平均HbA1c反映全孕期的血糖水平。采用Pearson相关分析探讨HbA1c与新生儿出生体重之间的关系; 利用受试者工作特征(ROC)曲线及Logistic回归分析探讨HbA1c预测GDM孕妇新生儿出生体重的价值; 依据不同指南HbA1c控制目标将孕中晚期平均HbA1c分为3个亚组,A组:HbA1c<5.5%、B组:5.5%≤HbA1c<6%、C组:6%≤HbA1c<6.5%。比较3个亚组子代出生时体重、6周体重及不良妊娠结局的差异。结果(1)孕中晚期平均HbA1c水平与新生儿出生体重呈线性相关(P<0.05)。(2)HbA1c预测巨大儿的ROC曲线下面积为0.681,95% CI:0.608～0.753,P<0.001。当HbA1c为5.89%时,预测巨大儿的敏感性与特异性分别为51.5%及80.5%。两因素Logistic回归分析示OR=2.307,95% CI:1.215～4.38, P=0.011。(3)C组新生儿出生体重、不良妊娠结局发生率均高于A组、B组(P<0.05),6周内每日体重增长量慢于A组和B组(P<0.05)。结论 孕中晚期平均HbA1c与GDM孕妇新生儿出生体重、不良妊娠结局及6周内日均体重增长量密切相关,HbA1c水平对巨大儿的发生有预测价值,且应控制在6%以内。
Abstract:
Objective To investigate the correlation between the average HbA1c in the second and third trimesters of GDM pregnant women and the birth weight and 6-week weight of their offspring.Methods The data of 556 cases of GDM pregnant women and the 6-week weight of their offspring were collected. The HbA1c of GDM pregnant women was tested every 4-6 weeks until delivery. The average HbA1c in the second and third trimesters reflected the blood glucose level of the whole pregnancy. Pearson correlation analysis was used to explore the relationship between HbA1c and neonatal birth weight. ROC curve and Logistic regression analysis were used to explore the value of HbA1c in predicting the neonatal birth weight of GDM pregnant women. According to different guidelines for HbA1c control targets, the average HbA1c in the second and third trimesters was divided into three subgroups. The differences of birth weight, 6-week weight, and adverse pregnancy outcomes of the three subgroups were compared.Results(1)The average HbA1c in the second and third trimester was linearly correlated with neonatal birth weight(P<0.05).(2)The area under the ROC curve of HbA1c in predicting macrosomia was 0.681,95% CI:0.608～0.753, P<0.001. When the HbA1c was 5.89%, the sensitivity and specificity of predicting macrosomia were 51.5% and 80.5%, respectively. Two-factor Logistic regression analysis showed that OR=2.307, 95% CI: 1.215-4.38, P=0.011.(3)The birth weight and adverse pregnancy outcomes of the group C were higher than those of the group A and B(P<0.05), and the daily weight growth was slower than that of the group A and B(P<0.05).Conclusion The average HbA1c in the second and third trimester is closely related to the birth weight, adverse pregnancy outcomes, and 6-week weight of the offspring of GDM pregnant women. Its level has predictive value for the occurrence of macrosomia and should be controlled within 6%.

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通信作者:李冬梅,Email:ldm1229@126.com
更新日期/Last Update: 2024-05-30