内分泌科

订阅

MedSci主页 / 所有栏目 / 内分泌科

Diabetologia：胎儿出生体重异常的预测因子

2012-12-07 丛广志 编译 Diabetologia

胎儿出生体重糖尿病
关注

　　英国一项新研究表明，糖尿病妇女孕前和孕期血糖控制不良与其胎儿出生体重异常相关。围孕期糖化血红蛋白（HbA1c ）升高，胎儿体重减轻；孕晚期HbA1c升高，胎儿出生体重增加。患有糖尿病微血管并发症的孕妇可能需要密切监测胎儿体重。论文发表于2012年12月《糖尿病学》（Diabetologia）杂志。 　　该研究收集了1996-2008年间参与“北方妊娠期糖尿病调查”（Northern

　　英国一项新研究表明，糖尿病妇女孕前和孕期血糖控制不良与其胎儿出生体重异常相关。围孕期糖化血红蛋白（HbA1c ）升高，胎儿体重减轻；孕晚期HbA1c升高，胎儿出生体重增加。患有糖尿病微血管并发症的孕妇可能需要密切监测胎儿体重。论文发表于2012年12月《糖尿病学》（Diabetologia）杂志。

　　该研究收集了1996-2008年间参与“北方妊娠期糖尿病调查”（Northern Diabetes in Pregnancy Survey）试验中正常单胎和死胎糖尿病孕妇围孕期资料。多因素回归分析胎儿出生体重异常的预测因子。

　　结果显示，孕前保健，孕晚期HbA1C增加及母亲BMI增加为胎儿出生体重增加的潜在可调节预测因子。孕期吸烟、孕晚期首次就诊和围孕期HbA1C增加为胎儿出生体重降低的潜在可调节独立预测因子。孕前并发肾病和视网膜病变为胎儿出生体重减轻的非调节独立性预测因子，而孕妇身材高大为胎儿出生体重增加的非调节预测因子。其他的胎儿出生体重增加的预测因子包括男胎、经产和晚育。糖尿病的类型与持续时间，社会经济状况和种族则与胎儿出生体重无关。



Aims/hypothesis
To investigate clinical and sociodemographic predictors of birthweight in singletons born to women with type 1 or type 2 diabetes.
Methods
Normally formed singleton live births and intrapartum stillbirths, born to women with pre-conception diabetes during 1996–2008, were identified from the population-based Northern Diabetes in Pregnancy Survey (n=1,505). Associations between potential predictors and birthweight were analysed by multiple regression.
Results
Potentially modifiable independent predictors of increase in birthweight were pre-pregnancy care (adjusted regression coefficient [b]=87.1 g; 95% CI 12.9, 161.3), increasing third-trimester HbA1c ≤7% (53 mmol/mol) (b=310.5 g per 1% [11 mmol/mol]; 95% CI 246.3, 374.7) and increasing maternal BMI (b=9.5 g per 1 kg/m2; 95% CI 3.5, 15.5). Smoking during pregnancy (b=145.1 g; 95% CI 231.4, 58.8), later gestation at first antenatal visit (b=15.0 g; 95% CI 26.9, 3.0) and higher peri-conception HbA1c (b=48.2 g; 95% CI 68.8, 27.6) were independently associated with birthweight reduction. Pre-pregnancy nephropathy (b=282.7 g; 95% CI 461.8, 103.6) and retinopathy (b=175.5 g; 95% CI 269.9, 81.0) were independent non-modifiable predictors of reduced birthweight, while greater maternal height was a non-modifiable predictor of increasing birthweight (b=17.8 g; 95% CI 12.3, 23.2). Other predictors of birthweight increase were male sex, multiparity and increasing gestational age at delivery. Type or duration of diabetes, socioeconomic status and ethnicity were not associated with continuous birthweight.
Conclusions/interpretation
Poor glycaemic control before and throughout pregnancy is associated with abnormal fetal growth, with increasing peri-conception HbA1c predicting weight reduction and increasing third-trimester HbA1c predicting increased birthweight. Women with microvascular complications of diabetes may require increased surveillance to detect fetal growth restriction.
    

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1759223, encodeId=8cb61e5922326, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sat Sep 28 18:42:00 CST 2013, time=2013-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1641340, encodeId=cbfc16413407e, content=<a href='/topic/show?id=0a448359311' target=_blank style='color:#2F92EE;'>#胎儿出生体重#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83593, encryptionId=0a448359311, topicName=胎儿出生体重)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da7322789798, createdName=ms1756883563247400, createdTime=Thu Jan 10 17:42:00 CST 2013, time=2013-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1636601, encodeId=b90e163660112, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat Mar 09 16:42:00 CST 2013, time=2013-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310575, encodeId=a4ee13105e5bd, content=<a href='/topic/show?id=25dc1002255e' target=_blank style='color:#2F92EE;'>#预测因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100225, encryptionId=25dc1002255e, topicName=预测因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Sun Dec 09 07:42:00 CST 2012, time=2012-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1440708, encodeId=0eb01440e0849, content=<a href='/topic/show?id=f99e3142e4d' target=_blank style='color:#2F92EE;'>#出生体重#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31427, encryptionId=f99e3142e4d, topicName=出生体重)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ffd4758992, createdName=ms9608593228839890, createdTime=Sun Dec 09 07:42:00 CST 2012, time=2012-12-09, status=1, ipAttribution=)]
    2013-09-28 ms5439512287675881

    #BET#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1759223, encodeId=8cb61e5922326, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sat Sep 28 18:42:00 CST 2013, time=2013-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1641340, encodeId=cbfc16413407e, content=<a href='/topic/show?id=0a448359311' target=_blank style='color:#2F92EE;'>#胎儿出生体重#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83593, encryptionId=0a448359311, topicName=胎儿出生体重)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da7322789798, createdName=ms1756883563247400, createdTime=Thu Jan 10 17:42:00 CST 2013, time=2013-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1636601, encodeId=b90e163660112, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat Mar 09 16:42:00 CST 2013, time=2013-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310575, encodeId=a4ee13105e5bd, content=<a href='/topic/show?id=25dc1002255e' target=_blank style='color:#2F92EE;'>#预测因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100225, encryptionId=25dc1002255e, topicName=预测因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Sun Dec 09 07:42:00 CST 2012, time=2012-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1440708, encodeId=0eb01440e0849, content=<a href='/topic/show?id=f99e3142e4d' target=_blank style='color:#2F92EE;'>#出生体重#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31427, encryptionId=f99e3142e4d, topicName=出生体重)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ffd4758992, createdName=ms9608593228839890, createdTime=Sun Dec 09 07:42:00 CST 2012, time=2012-12-09, status=1, ipAttribution=)]
    2013-01-10 ms1756883563247400

    #胎儿出生体重#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1759223, encodeId=8cb61e5922326, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sat Sep 28 18:42:00 CST 2013, time=2013-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1641340, encodeId=cbfc16413407e, content=<a href='/topic/show?id=0a448359311' target=_blank style='color:#2F92EE;'>#胎儿出生体重#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83593, encryptionId=0a448359311, topicName=胎儿出生体重)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da7322789798, createdName=ms1756883563247400, createdTime=Thu Jan 10 17:42:00 CST 2013, time=2013-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1636601, encodeId=b90e163660112, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat Mar 09 16:42:00 CST 2013, time=2013-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310575, encodeId=a4ee13105e5bd, content=<a href='/topic/show?id=25dc1002255e' target=_blank style='color:#2F92EE;'>#预测因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100225, encryptionId=25dc1002255e, topicName=预测因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Sun Dec 09 07:42:00 CST 2012, time=2012-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1440708, encodeId=0eb01440e0849, content=<a href='/topic/show?id=f99e3142e4d' target=_blank style='color:#2F92EE;'>#出生体重#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31427, encryptionId=f99e3142e4d, topicName=出生体重)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ffd4758992, createdName=ms9608593228839890, createdTime=Sun Dec 09 07:42:00 CST 2012, time=2012-12-09, status=1, ipAttribution=)]
    2013-03-09 ms9608593228839890

    #DIA#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1759223, encodeId=8cb61e5922326, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sat Sep 28 18:42:00 CST 2013, time=2013-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1641340, encodeId=cbfc16413407e, content=<a href='/topic/show?id=0a448359311' target=_blank style='color:#2F92EE;'>#胎儿出生体重#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83593, encryptionId=0a448359311, topicName=胎儿出生体重)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da7322789798, createdName=ms1756883563247400, createdTime=Thu Jan 10 17:42:00 CST 2013, time=2013-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1636601, encodeId=b90e163660112, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat Mar 09 16:42:00 CST 2013, time=2013-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310575, encodeId=a4ee13105e5bd, content=<a href='/topic/show?id=25dc1002255e' target=_blank style='color:#2F92EE;'>#预测因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100225, encryptionId=25dc1002255e, topicName=预测因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Sun Dec 09 07:42:00 CST 2012, time=2012-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1440708, encodeId=0eb01440e0849, content=<a href='/topic/show?id=f99e3142e4d' target=_blank style='color:#2F92EE;'>#出生体重#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31427, encryptionId=f99e3142e4d, topicName=出生体重)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ffd4758992, createdName=ms9608593228839890, createdTime=Sun Dec 09 07:42:00 CST 2012, time=2012-12-09, status=1, ipAttribution=)]
    2012-12-09 宋威

    #预测因子#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1759223, encodeId=8cb61e5922326, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sat Sep 28 18:42:00 CST 2013, time=2013-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1641340, encodeId=cbfc16413407e, content=<a href='/topic/show?id=0a448359311' target=_blank style='color:#2F92EE;'>#胎儿出生体重#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83593, encryptionId=0a448359311, topicName=胎儿出生体重)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da7322789798, createdName=ms1756883563247400, createdTime=Thu Jan 10 17:42:00 CST 2013, time=2013-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1636601, encodeId=b90e163660112, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat Mar 09 16:42:00 CST 2013, time=2013-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310575, encodeId=a4ee13105e5bd, content=<a href='/topic/show?id=25dc1002255e' target=_blank style='color:#2F92EE;'>#预测因子#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100225, encryptionId=25dc1002255e, topicName=预测因子)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6105386, createdName=宋威, createdTime=Sun Dec 09 07:42:00 CST 2012, time=2012-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1440708, encodeId=0eb01440e0849, content=<a href='/topic/show?id=f99e3142e4d' target=_blank style='color:#2F92EE;'>#出生体重#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31427, encryptionId=f99e3142e4d, topicName=出生体重)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ffd4758992, createdName=ms9608593228839890, createdTime=Sun Dec 09 07:42:00 CST 2012, time=2012-12-09, status=1, ipAttribution=)]
    2012-12-09 ms9608593228839890

    #出生体重#

    0