MATERNAL POSTPRANDIAL GLUCOSE-LEVELS AND INFANT BIRTH-WEIGHT - THE DIABETES IN EARLY-PREGNANCY STUDY
MATERNAL POSTPRANDIAL GLUCOSE-LEVELS AND INFANT BIRTH-WEIGHT - THE DIABETES IN EARLY-PREGNANCY STUDY
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DOI：
10.1016/0002-9378(91)90637-7
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发表时间：
1991-01-01
影响因子：
9.8
通讯作者：
AARONS, JH
中科院分区：
文献类型：
--
作者：
JOVANOVICPETERSON, L;PETERSON, CM;AARONS, JH
糖尿病妇女所产巨大儿的原因尚不完全清楚。 国家儿童健康和人类发展研究所-妊娠早期糖尿病研究招募了怀孕前的胰岛素依赖型糖尿病妇女和对照组妇女，提供了一个探讨产妇体重与出生体重百分位数之间关系的机会。 数据来自323名糖尿病患者和361名对照组女性。 在孕早期每隔一周测量空腹和非空腹静脉血糖，此后每月测量一次。 糖化血红蛋白在孕早期每周测量一次，此后每月测量一次。 糖尿病妇女的婴儿出生体重达到或超过第90百分位数的比例高于对照妇女的婴儿（28.5%对13.1%，p < 0.001）。 尽管孕早期非空腹血糖和糖化血红蛋白水平与婴儿出生体重呈正相关，（p < 0.001和p = 0.008），当分析对随后三个月的变量进行调整时，这些值变得不显著，而经前三个月血糖值调整后的第三个月非空腹血糖水平则是百分位出生体重的更强预测因子（p = 0.001）。 在调整母亲高血压、吸烟和体重指数后，上述关系仍然存在。 总之，监测非空腹血糖水平，而不是空腹水平，这是更常见的监测在临床实践中，是必要的，以防止巨大儿。
The cause of macrosomia in the infant of the diabetic woman is still not completely defined. The National Institute of Child Health and Human Development-Diabetes in Early Pregnancy Study, which recruited insulin-dependent diabetic and control women before conception, provided an opportunity to address the relationship between maternal glycemia and percentile birth weight. Data were analyzed from 323 diabetic and 361 control women. Fasting and nonfasting venous plasma glucose were measured on alternate weeks in the first trimester and monthly thereafter. Glycosylated hemoglobin was measured weekly in the first trimester and monthly thereafter. More infants of the diabetic women were at or above the 90th percentile for birth weight than infants of control women (28.5% versus 13.1%, p < 0.001). Although first-trimester nonfasting glucose and glycosylated hemoglobin levels were positively correlated with infant birth weight (p < 0.001 and p = 0.008), when the analyses were adjusted for the variables of the subsequent trimesters the values became insignificant, whereas the third-trimester nonfasting glucose levels adjusted for values in prior trimesters emerged as the stronger predictor of percentile birth weight (p = 0.001). After adjusting for maternal hypertension, smoking, and ponderal index, the above relationships remained. In conclusion, monitoring of nonfasting glucose levels rather than the fasting levels, which are more commonly monitored in clinical practice, are necessary to prevent macrosomia.