RELATIONSHIP OF FETAL MACROSOMIA TO A 75G GLUCOSE CHALLENGE TEST IN NONDIABETIC PREGNANT-WOMEN
RELATIONSHIP OF FETAL MACROSOMIA TO A 75G GLUCOSE CHALLENGE TEST IN NONDIABETIC PREGNANT-WOMEN
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DOI：
10.1111/j.1479-828x.1994.tb01033.x
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发表时间：
1994-02-01
影响因子：
1.7
通讯作者：
RIZVI, JH
中科院分区：
文献类型：
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作者：
KHAN, KS;SYED, AH;RIZVI, JH
在非糖尿病妇女中，我们测定了妊娠16-20周进行75 g口服葡萄糖激发试验（GCT） 2小时后的血浆葡萄糖值与足月分娩（37-41周）巨大儿发生率的关系。从1988年到1990年，在一个系统的筛查项目中，对从1331名女性中收集的前瞻性数据进行了回顾性分析。排除妊娠期糖尿病或糖耐量受损的妇女（n = 53）。其余（n = 1278）没有葡萄糖耐受不良的证据，其中1215名妇女GCT检测血糖正常（口服75 g葡萄糖负荷2小时后< 7.8 mmol/L）， 63名妇女GCT异常但葡萄糖耐量试验值未异常。GCT值分为5组：A组（< 4.5 mmol/L）、B组（4.5 ~ 5.5 mmol/L）、C组（5.6 ~ 6.6 mmol/L）、D组（6.7 ~ 7.7 mmol/L）、E组（> 7.8 mmol/L）。研究的变量包括年龄、胎次、分娩胎龄和巨大儿的发生率。以出生体重>4 kg作为巨大儿的定义，随着GCT中血浆葡萄糖值从A组（< 4.5 mmol/L）增加到E组（> 7.8 mmol/L），发病率从1.2%增加到9.5%。当使用出生体重第90和95百分位作为巨大儿的定义时，发病率分别从7.2%增加到15.8%和2.9%增加到9.5%。相关性线性趋势检验有显著性意义（p < 0.01）。这些结果不受胎次或分娩胎龄的影响。这些数据提供了新的信息，有助于解释巨大儿的生物学，也强调需要更严格的诊断和治疗葡萄糖不耐受标准。
We determined in nondiabetic women, the relationship of plasma glucose values obtained 2 hours after a 75 g oral glucose challenge test (GCT) at 16-20 weeks' gestation, with the incidence of macrosomia in term deliveries (37-41 weeks' gestation). From 1988-1990, in a systematic screening programme data collected prospectively from 1,331 women were analysed retrospectively. Women with gestational diabetes or impaired glucose tolerance (n = 53) were excluded. The rest (n = 1,278) had no evidence of glucose intolerance including 1,215 women with normal plasma glucose by GCT (< 7.8 mmol/L 2 hours after 75 g oral glucose load) and 63 women with abnormal GCT but no abnormal value at a glucose tolerance test. The GCT values were divided into 5 groups: Group A (< 4.5 mmol/L), B (4.5-5.5 mmol/L), C (5.6-6.6 mmol/L), D (6.7-7.7 mmol/L) and E (> 7.8 mmol/L). The variables studied were age, parity, gestational age at delivery and incidence of macrosomia.Using >4 kg birth-weight as the definition of macrosomia, the incidence increased from 1.2% to 9.5% with increasing plasma glucose values in the GCT from Group A (< 4.5 mmol/L) to E(> 7.8 mmol/L). Similar trends of increasing incidences from 7.2% to 15.8% and 2.9% to 9.5% were noted when 90th and 95th birth-weight percentiles, respectively were used as definitions of macrosomia. The test of linear trend in this association was significant (p < 0.01). These results were not influenced by parity or gestational age at delivery.These data provide new information to help explain the biology of macrosomia and also highlight the need for stricter criteria for diagnosis and treatment of glucose intolerance.