妊娠期糖尿病患者脂代谢异常对新生儿出生体质量的影响

摘要

目的:研究妊娠期糖尿病(GDM)患者脂代谢异常对新生儿出生体质量的影响,为合理管理妊娠期糖尿病孕妇提供临床参考.方法:106例妊娠女性分为妊娠期糖尿病(GDM组,n=50)组、妊娠期糖耐量受损(GIGT组,n=24)组及糖耐量正常(NGT组,n=32).比较3组孕妇血脂水平、孕期体质量增加及相关围产资料.结果:GDM组总胆固醇(TC)及三酰甘油(TG)水平均高于GIGT和NGT组,差异有统计学意义(P＜0.05).3组孕妇分娩前体质量差异有统计意义(P＜0.01),且GDM组明显高于其他2组.GDM组新生儿出生体质量、孕妇术中羊水粪染及新生儿转入重症监护病房(NICU)的概率高于其他2组,差异有统计学意义(P＜0.05)；GDM组孕妇空腹血糖、TG水平及孕妇孕期体质量增加与新生儿出生体质量间存在正相关(r分别为0.528、0.632、0.585,P＜0.05).结论:在控制血糖的基础上,积极控制血脂水平,可减少巨大儿的发生及围产期并发症,保障母婴安全.%Objective: To study the influences of abnormal lipid metabolism in patients with gestational diabetes mellitus (GDM) on neonatal birth weight and provide clinical references for reasonable management of GDM. Methods: A total of 106 pregnant women were divided into GDM group (n=50), gestational impaired glucose tolerance (GIGT) group (n= 24) and normal glucose tolerance (NGT) group (n=32). The values of blood lipid levels, weight gain during pregnancy and perinatal data were recorded and compared in three groups. Results: The levels of total cholesterol (TC) and triacylglycerol (TG) were significantly higher in GDM group than those of GIGT group and NGT group (P < 0.05). The average weight of pregnant women was significantly different between three groups, and which was higher in GDM group than that of other two groups (P < 0.01). The neonatal birth weight, meconium-stained and the probability that newborns were transferred to the neonatal intensive care unit (NICU) were significantly higher in GDM group than those of other two groups (P < 0.05). The levels of blood glucose, TG and increased body weight of pregnancy were positively correlated with the neonatal body weight (r=0.528, 0.632 and 0.585, P < 0.05). Conclusion: The perinatal complications can be reduced by control blood glucose and blood lipid levels, ensuring the safe motherhood.