Small-for-gestational age and its association with maternal blood glucose, body mass index and stature: a perinatal cohort study among Chinese women.
Small-for-gestational age and its association with maternal blood glucose, body mass index and stature: a perinatal cohort study among Chinese women.
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DOI：
10.1136/bmjopen-2015-010984
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发表时间：
2016-09-15
期刊：
影响因子：
2.9
通讯作者：
Liu J
中科院分区：
文献类型：
--
作者：
Leng J;Hay J;Liu G;Zhang J;Wang J;Liu H;Yang X;Liu J
探讨母亲低血糖（BG）、低体重指数（BMI）和身材矮小是否对分娩小于胎龄儿（SGA）的风险有联合影响。从围产期队列的妇女进行了随访，从接受围产期保健分娩。2011年6月至2012年10月，中国天津市北辰区。1572名年龄19-39岁的女性，在妊娠期糖尿病筛查（妊娠24-28周）时身高、BMI和BG水平的有效值，葡萄糖激发试验<7.8 mmol/L和单胎分娩（妊娠≥37周）。 SGA定义为天津市单胎出生体重<10 th百分位数。164例新生儿（10.4%）被确定为SGA。多因素Logistic回归分析显示，母亲BG、BMI和身高每增加1 SD，SGA分娩的OR（95% CI）分别为0.84（0.72 ~ 0.98）、0.61（0.49 ~ 0.74）和0.64（0.54 ~ 0.76）。当对母体BG（<6.0 vs ≥6.0 mmol/L）、BMI（<24 vs ≥24 kg/m2）和身高（<160.0 vs ≥160.0 cm）进行二分时，BG、BMI和身高均处于较低类别的孕妇分娩SGA新生儿的几率是BG、BMI和身高均处于较高类别的对照组的0.8倍（OR（95% CI）8.01（3.78至16.96））。 在较低类别中有任何2个变量的妇女中，SGA分娩的几率高出1.2 -4倍。母亲低血糖与SGA婴儿的风险增加有关。SGA的风险显着增加时，母亲也是短，有一个低的BMI。这可能是一个有用的临床工具，以确定妇女在分娩时有一个SGA婴儿的风险较高。
To examine whether maternal low blood glucose (BG), low body mass index (BMI) and small stature have a joint effect on the risk of delivery of a small-for-gestational age (SGA) infant. Women from a perinatal cohort were followed up from receiving perinatal healthcare to giving birth. Beichen District, Tianjin, China between June 2011 and October 2012. 1572 women aged 19–39 years with valid values of stature, BMI and BG level at gestational diabetes mellitus screening (gestational weeks 24–28), glucose challenge test <7.8 mmol/L and singleton birth (≥37 weeks’ gestation). SGA was defined as birth weight <10th centile for gender separated gestational age of Tianjin singletons. 164 neonates (10.4%) were identified as SGA. From multiple logistic regression models, the ORs (95% CI) of delivery of SGA were 0.84 (0.72 to 0.98), 0.61 (0.49 to 0.74) and 0.64 (0.54 to 0.76) for every 1 SD increase in maternal BG, BMI and stature, respectively. When dichotomises, maternal BG (<6.0 vs ≥6.0 mmol/L), BMI (<24 vs ≥24 kg/m2) and stature (<160.0 vs ≥160.0 cm), those with BG, BMI and stature all in the lower categories had ∼8 times higher odds of delivering an SGA neonate (OR (95% CI) 8.01 (3.78 to 16.96)) relative to the reference that had BG, BMI and stature all in the high categories. The odds for an SGA delivery among women who had any 2 variables in the lower categories were ∼2–4 times higher. Low maternal BG is associated with an increased risk of having an SGA infant. The risk of SGA is significantly increased when the mother is also short and has a low BMI. This may be a useful clinical tool to identify women at higher risk for having an SGA infant at delivery.
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