孕期葡萄糖不耐受和与出生体重相关的并发症
Jacqueline Maya1, Daryl J Selen, Tanayott Thaweethai
1Diabetes Unit, the Department of Medicine, the Department of Pediatrics, the Biostatistics Center, and the Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, the Broad Institute of MIT and Harvard, the Department of Biostatistics, Harvard T.H. Chan School of Public Health, the Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, and the Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, Massachusetts; the Division of Endocrinology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island; and the Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, Florida.
孕期葡萄糖不耐受症的孕妇面临着高孕年龄出生体重 (LGA) 和相关并发症的风险增加. 早期识别和管理对于改善妊娠结果至关重要.
科学领域:
- 产科和妇科 产科和妇科
- 内分泌学 在内分泌学.
- 围产儿医学 围产儿医学
背景情况:
- 孕期葡萄糖不耐受 (GGI) 是通过不正常的葡萄糖负载测试结果来定义的,这些测试结果不符合孕期糖尿病 (GDM) 标准.
- 了解与GGI相关的风险对于优化母亲和婴儿健康结果至关重要.
- 之前的研究集中在GDM上,对GGI的特定风险的知识存在差距.
研究的目的:
- 评估妊娠期葡萄糖不耐受和高妊娠年龄出生体重 (LGA) 的风险之间的关联.
- 评估妊娠期葡萄糖不耐受症怀孕中与出生体重相关并发症的发生率.
- 为了比较GGI患者和正常葡萄糖耐受症患者之间的不良妊娠结果.
主要方法:
- 对46,989个单独怀孕的回顾性队列研究.
- 葡萄糖耐受性的分类:正常,GGI (正常的OGTT或一个异常的OGTT) 和GDM (两个或更多异常的OGTT值).
- 用于计算LGA和其他不利结果的调整赔率比率的概括估计方程.
主要成果:
- 孕期葡萄糖不耐受与与正常葡萄糖耐受性 (aOR 1.35) 相比,LGA的几率明显更高.
- 特定的GGI亚型也显示LGA几率增加 (正常的OGTT aOR1.21;一个异常的OGTT aOR1.77).
- 诸如剖腹产和肩膀缩等不良结果在GGI中更频繁,其中一个异常的OGTT值.
结论:
- 孕期葡萄糖不耐症是与出生体重相关的不良结果的独立风险因素.
- 进一步研究GGI降糖策略是有必要的,以减轻这些风险.
- 这项研究强调了识别和管理GGI以改善围产期健康的重要性.
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