PDF(Pubmed)
Abstract：
Small for gestational age (SGA) poses a significant concern for newborns, being linked to neonatal complications and potential metabolic disorders in adulthood, especially when born to mothers with gestational diabetes mellitus (GDM), elevating their risk of complications and mortality. However, the pregnancy risk factors and glycaemic control associated with SGA infants born to mothers with GDM remain unclear.
To identify the pregnancy risk factors and glycaemic control associated with SGA infants born to mothers with GDM.
This case-control study was conducted among 1910 women with GDM in China. Data were collected by the integrated electronic medical record system. Using 1:4 propensity score matching analysis, we adjusted for gestational age as confounder. Univariate and multivariate analyses were performed to identify risk factors.
Risk factors for SGA born to mothers with GDM included a history of low birth weight, gestational hypertension, oligohydramnios, short maternal height, underweight pre-pregnancy body mass index and inadequate weight growth. While SGA was protected by weakly positive ketonuria levels in the first trimester, multiparous, anaemia and previous uterine scar were protective factors for SGA. Moreover, 2-hour postprandial glucose and haemoglobin A1c in the second trimester, as well as the 0-hour and 2-hour 75 g oral glucose tolerance test (OGTT) were linked to risk of SGA.
SGA infants are the result of multifactorial interactions among GDM pregnant women. Notably, glycaemic control levels were associated with SGA. There is a need for enhanced perinatal monitoring and antenatal care to reduce SGA.
To identify the pregnancy risk factors and glycaemic control associated with SGA infants born to mothers with GDM.
This case-control study was conducted among 1910 women with GDM in China. Data were collected by the integrated electronic medical record system. Using 1:4 propensity score matching analysis, we adjusted for gestational age as confounder. Univariate and multivariate analyses were performed to identify risk factors.
Risk factors for SGA born to mothers with GDM included a history of low birth weight, gestational hypertension, oligohydramnios, short maternal height, underweight pre-pregnancy body mass index and inadequate weight growth. While SGA was protected by weakly positive ketonuria levels in the first trimester, multiparous, anaemia and previous uterine scar were protective factors for SGA. Moreover, 2-hour postprandial glucose and haemoglobin A1c in the second trimester, as well as the 0-hour and 2-hour 75 g oral glucose tolerance test (OGTT) were linked to risk of SGA.
SGA infants are the result of multifactorial interactions among GDM pregnant women. Notably, glycaemic control levels were associated with SGA. There is a need for enhanced perinatal monitoring and antenatal care to reduce SGA.
摘要：
背景：小于胎龄（SGA）对新生儿来说是一个重要的问题，与成年后的新生儿并发症和潜在的代谢紊乱有关，特别是当母亲患有妊娠期糖尿病（GDM）时，提高并发症和死亡率的风险。然而,与GDM母亲所生的SGA婴儿相关的妊娠危险因素和血糖控制仍不清楚.
目的：确定GDM母亲所生的SGA婴儿的妊娠危险因素和血糖控制。
方法：这项病例对照研究是在中国1910例GDM妇女中进行的。数据由集成电子病历系统收集。使用1:4倾向得分匹配分析，我们调整了胎龄作为混淆因素.进行单因素和多因素分析以确定危险因素。
结果：GDM母亲所生的SGA的危险因素包括低出生体重史，妊娠期高血压,羊水过少,产妇身材矮小，体重过轻的孕前体重指数和体重增长不足。虽然SGA在孕早期受到酮尿症弱阳性水平的保护，多胎,贫血和既往子宫瘢痕是SGA的保护因素。此外，孕中期2小时餐后血糖和血红蛋白A1c，以及0小时和2小时75g口服葡萄糖耐量试验(OGTT)与SGA风险相关.
结论：SGA婴儿是GDM孕妇之间多因素相互作用的结果。值得注意的是,血糖控制水平与SGA相关。需要加强围产期监测和产前护理以减少SGA。
目的：确定GDM母亲所生的SGA婴儿的妊娠危险因素和血糖控制。
方法：这项病例对照研究是在中国1910例GDM妇女中进行的。数据由集成电子病历系统收集。使用1:4倾向得分匹配分析，我们调整了胎龄作为混淆因素.进行单因素和多因素分析以确定危险因素。
结果：GDM母亲所生的SGA的危险因素包括低出生体重史，妊娠期高血压,羊水过少,产妇身材矮小，体重过轻的孕前体重指数和体重增长不足。虽然SGA在孕早期受到酮尿症弱阳性水平的保护，多胎,贫血和既往子宫瘢痕是SGA的保护因素。此外，孕中期2小时餐后血糖和血红蛋白A1c，以及0小时和2小时75g口服葡萄糖耐量试验(OGTT)与SGA风险相关.
结论：SGA婴儿是GDM孕妇之间多因素相互作用的结果。值得注意的是,血糖控制水平与SGA相关。需要加强围产期监测和产前护理以减少SGA。
