Disproportionate body composition and neonatal outcome in offspring of mothers with and without gestational diabetes mellitus.
Disproportionate body composition and neonatal outcome in offspring of mothers with and without gestational diabetes mellitus.
复制标题
DOI：
10.2337/dc13-0899
复制
发表时间：
2013-11
期刊：
影响因子：
16.2
通讯作者：
Pasupathy D
中科院分区：
文献类型：
--
作者：
Persson M;Fadl H;Hanson U;Pasupathy D
高出生体重是新生儿并发症的危险因素。尚不清楚风险是否因身体比例而异。本研究的主要目的是确定不良妊娠结局的风险与按母亲妊娠期糖尿病（GDM）分层的大于胎龄儿（LGA）的身体比例。对1998-2007年GDM妇女（n = 1，547）所生的所有LGA（出生体重[BW] >第90百分位数）婴儿进行的基于人群的研究。对照组包括母亲无糖尿病的LGA婴儿（n = 83，493）。数据来自瑞典出生登记处。如果体重指数（PI）（体重（克）/身长（厘米3））≤第90百分位数，则婴儿被归类为比例（P-LGA），如果PI >第90百分位数，则婴儿被归类为不比例（D-LGA）。主要结局是复合发病率：5分钟Apgar评分0-3分、产伤、呼吸系统疾病、低血糖或高胆红素血症。Logistic回归分析用于获得不良结局的比值比（OR）。与对照组相比，GDM妊娠的复合新生儿发病率风险增加，但两组中P-和D-LGA之间的风险相似。无糖尿病母亲所生的D-LGA婴儿发生产伤（OR 1.19 [95%CI 1.09-1.30]）和低血糖（1.23 [1.11-1.37]）的风险显著增加。两组中D-LGA婴儿的剖腹产几率显著增加。GDM后代的复合新生儿发病率的风险显着增加。在妊娠合并和不合并GDM的情况下，P-和D-LGA的复合新生儿发病率风险相当。
High birth weight is a risk factor for neonatal complications. It is not known if the risk differs with body proportionality. The primary aim of this study was to determine the risk of adverse pregnancy outcome in relation to body proportionality in large-for-gestational-age (LGA) infants stratified by maternal gestational diabetes mellitus (GDM). Population-based study of all LGA (birth weight [BW] >90th percentile) infants born to women with GDM (n = 1,547) in 1998–2007. The reference group comprised LGA infants (n = 83,493) born to mothers without diabetes. Data were obtained from the Swedish Birth Registry. Infants were categorized as proportionate (P-LGA) if ponderal index (PI) (BW in grams/length in cm3) was ≤90th percentile and as disproportionate (D-LGA) if PI >90th percentile. The primary outcome was a composite morbidity: Apgar score 0–3 at 5 min, birth trauma, respiratory disorders, hypoglycemia, or hyperbilirubinemia. Logistic regression analysis was used to obtain odds ratios (ORs) for adverse outcomes. The risk of composite neonatal morbidity was increased in GDM pregnancies versus control subjects but comparable between P- and D-LGA in both groups. D-LGA infants born to mothers without diabetes had significantly increased risk of birth trauma (OR 1.19 [95% CI 1.09–1.30]) and hypoglycemia (1.23 [1.11–1.37]). D-LGA infants in both groups had significantly increased odds of Cesarean section. The risk of composite neonatal morbidity is significantly increased in GDM offspring. In pregnancies both with and without GDM, the risk of composite neonatal morbidity is comparable between P- and D-LGA.