RELATIONSHIP OF FETAL MACROSOMIA TO MATERNAL POSTPRANDIAL GLUCOSE CONTROL DURING PREGNANCY
RELATIONSHIP OF FETAL MACROSOMIA TO MATERNAL POSTPRANDIAL GLUCOSE CONTROL DURING PREGNANCY
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DOI：
10.2337/diacare.15.10.1251
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发表时间：
1992-10-01
期刊：
影响因子：
16.2
通讯作者：
MAIN, EK
中科院分区：
文献类型：
--
作者：
COMBS, CA;GUNDERSON, E;MAIN, EK
目的：确定母亲高血糖与胎儿巨大儿最密切相关的胎龄；确定巨大儿是否与空腹血糖升高、餐后血糖升高或两者均升高有关；并探讨巨大儿与母体胰岛素剂量和热量摄入的关系。研究设计和方法：从妊娠13至36周，对111名连续患有乙型糖尿病的妊娠妇女进行纵向研究。巨大儿的定义是出生体重bb0根据加州标准的胎龄第90百分位数。在餐前和餐后血糖、GHb、胰岛素剂量、宏量营养素摄入量和其他一些母体变量方面，将生下巨体婴儿的妇女与没有生下巨体婴儿的妇女进行比较。结果：32例（29%）发生了巨大儿，尽管一些措施表明妊娠期间血糖控制合理。在产妇年龄、孕前体重、糖尿病病程、White class、宏量营养素摄入量、GHb或空腹血糖方面，分娩巨婴的妇女与未分娩巨婴的妇女没有差异。巨大儿与妊娠32周较高的餐后血糖水平和妊娠29至36周较低的胰岛素剂量有关。在多元logistic回归中，只有在妊娠29 - 32周，巨大儿与餐后血糖显著相关。餐后血糖值< 7.3 mM (
OBJECTIVE - To determine the gestational ages at which maternal hyperglycemia is most closely related to fetal macrosomia; to determine whether macrosomia is related to elevations of fasting glucose, postprandial glucose, or both; and to assess the relationship of macrosomia to maternal insulin dose and caloric intake.RESEARCH DESIGN AND METHODS - One hundred eleven consecutive pregnant women with Class B through RF diabetes were studied longitudinally from 13 to 36 wk gestation. Macrosomia was defined by birthweight >90th percentile for gestational age based on California norms. Women who delivered macrosomic infants were compared with those without macrosomic infants on pre- and postprandial blood glucose, GHb, insulin dose, macronutrient intake, and several other maternal variables.RESULTS - Macrosomia occurred in 32 (29%) cases, although several measures indicated reasonable glycemic control throughout pregnancy. Women delivering macrosomic infants did not differ from those without macrosomic infants in maternal age, prepregnant weight, duration of diabetes, White class, macronutrient intake, GHb, or fasting glucose. Macrosomia was associated with higher postprandial glucose levels up to 32 wk gestation and lower insulin doses from 29 to 36 wk gestation. In multiple logistic regression, macrosomia was significantly associated with postprandial glucose only between 29 and 32 wk gestation. Postprandial glucose values < 7.3 mM (