The influence of obesity and diabetes on the prevalence of macrosomia
The influence of obesity and diabetes on the prevalence of macrosomia
复制标题
DOI：
10.1016/j.ajog.2004.05.052
复制
发表时间：
2004-09-01
影响因子：
9.8
通讯作者：
Catalano, PM
中科院分区：
文献类型：
--
作者：
Ehrenberg, HM;Mercer, BM;Catalano, PM
目的：本研究是为了确定异常pregravid产妇体型和糖尿病的患病率的相对贡献的大的胎龄infants.Study design：产妇和新生儿记录单胎足月（大于或等于37周的估计胎龄）分娩1997年1月至2001年6月进行了审查。受试者以妊娠前体重指数（BMI）为特征，分为体重不足（BMI < 19.8 kg/m2）、正常（BMI 19.8-25 kg/m2）、超重（BMI 25.1-30 kg/m2）和肥胖（BMI > 30 kg/m2）亚组。糖尿病分为妊娠期糖尿病、单纯饮食治疗（A1 GDM）或胰岛素治疗（A2 GDM）和妊娠期糖尿病（PDM）。新生儿体重大于胎龄第90百分位数，根据已发表的当地出生体重数据，定义为大于胎龄（LGA）。将体重不足、超重和肥胖妇女的LGA分娩风险与孕前BMI正常的妇女进行比较。多元回归模型，包括产次，新生儿性别，体重指数，种族，和糖尿病，被构建来检查异常体重指数和糖尿病对LGA婴儿分娩风险的相对影响。包括12，950例分娩的完整数据（1，640例[13.0%]体重不足，2，991例[23.7%]超重，2，928例[23.2%]肥胖）。LGA分娩影响了11.8%的研究样本; 303例（2.3%）受试者患有A1 GDM，94例（0.7%）患有A2 GDM，133例（1.6%）患有PDM。与BMI正常的受试者相比，肥胖妇女的LGA分娩风险增加（16.8% vs 10.5%; P
Objective: This study was undertaken to determine the relative contribution of abnormal pregravid maternal body habitus and diabetes on the prevalence of large-for-gestational-age infants.Study design: Maternal and neonatal records for singleton term (greater than or equal to 37weeks' estimated gestational age) deliveries January 1997 through June 2001 were reviewed. Subjects were characterized by pregravid body mass index (BMI), divided into underweight (BMI < 19.8 kg/m(2)), normal (BMI 19.8-25 kg/m(2)), overweight (BMI 25.1-30 kg/m(2)), and obese (BMI > 30 kg/m(2)) subgroups. Diabetes was classified as gestational, treated with diet alone (A1GDM), or with insulin (A2GDM), and pregestaional diabetes (PDM). Newborn weight greater than the 90th percentile for gestational age, based on published local birth weight data, defined large for gestational age (LGA). The risk of LGA delivery for underweight, overweight, and obese women were compared with that of women with normal pregravid BMI. Multiple regression models, including parity, newborn sex, BMI, race, and diabetes, were constructed to examine the relative effect of abnormal BMI and diabetes on the risk of the delivery of an LGA infant.Results: Complete data for 12,950 deliveries were included (1,640 [13.0%] underweight, 2,991 [23.7%] overweight, and 2,928 [23.2%] obese). LGA delivery affected 11.8% of the study sample; 303 (2.3%) of subjects had A1GDM, whereas 94 (0.7%) had A2GDM, and 133 (1.6%) had PDM. Compared with normal BMI subjects, obese women were at elevated risk for LGA delivery (16.8% vs 10.5%; P