摘要
目的探讨妊娠期总体重增加(GWG)及妊娠期糖尿病(GDM)对于B超估测胎儿体重准确性的影响。方法选择2016年9月至2017年11月在北京医院就诊的1404例分娩产妇为研究对象进行回顾性分析,收集孕产妇妊娠期产检各阶段体重、GDM患病情况、新生儿实际出生体重与分娩前1周内B超估测胎儿体重数据。按总GWG分为总GWG过少组(279例)、正常组(570例)和过多组(555例),采用方差分析及logistic回归分析比较不同组间B超估测胎儿体重误差及巨大儿预测情况,分析总GWG及GDM对于B超估测新生儿出生体重准确性影响。结果妊娠期总GWG影响B超估计出生体重实际误差,总GWG过少组B超预测出生体重实际误差低于正常组[(-19.3±238.0)比(52.5±255.5)g,P<0.05],总GWG过多组实际误差高于正常组[(84.1±269.2)比(52.5±255.5)g,P<0.05]。但对于新生儿出生体重准确性估计组间差异无统计学意义(P>0.05)。GDM对于B超估计出生体重的误差值影响不明显,但GDM增加B超预测新生儿体重不准确风险(风险比1.483,95%可信区间1.101~1.998)。总GWG及GDM组间对于巨大儿预测灵敏度、特异度方面差异均无统计学意义(均P>0.05)。结论总GWG及GDM在一定程度可影响B超估测胎儿体重准确性,总GWG及GDM不影响巨大儿预测的灵敏度及特异度。
Objective To explore effects of gestational weight gain(GWG)and gestational diabetes mellitus(GDM)on the accuracy of sonographically estimated neonatal weight near delivery.Methods A total of 1404 cases of pregnant women in Beijing Hospital from September 2016 to November 2017 were include in retrospective analysis.Trimester-specific gestational weight gain,oral glucose tolerance test,birth weight and estimated neonatal weight at 1-week before delivery were collected.The patients were classified into inadequate GWG(279 cases),normal GWG(570 cases)and excessive GWG(555 cases).ANOVA and logistic regression analysis were used to compare the weight estimation errors of fetal body weight and the prediction of macrosomia by B-ultrasound between different groups,and to analyze the effect of total GWG and GDM on the accuracy of sonographically estimated neonatal weight.Results The total GWG effected actual error of birth weight and estimated neonatal weight,the actual error of B-ultrasound prediction of birth weight in the inadequate GWG group was lower than that in the normal group[(-19.3±238.0)vs(52.5±255.5)g,P<0.05],and the actual error in the excessive GWG group was higher than that in the normal group[(84.1±269.2)vs(52.5±255.5)g,P<0.05].But it had no significant effect on the accuracy of sonographic estimations of neonatal weight.GDM had little effect on the actual error and absolute error,but it increased the risk of inaccurate estimations of neonatal weight(odds ratio 1.483,95%confidence interval 1.101-1.998).There was no significant difference in the sensitivity,specificity of the prediction of macrosomia among the total GWG and GDM groups.Conclusion The total GWG during pregnancy and GDM may effect the accuracy of sonographically estimated neonatal weight to a certain extent.Neither GWG nor GDM has effect on the sensitivity,specificity of the prediction of macrosomia.
作者
李怡婧
郭立新
赵晓东
Li Yijing;Guo Lixin;Zhao Xiaodong(Department of Endocrinology,Beijing Hospital,Beijing 100730,China;Department of Obstetrics and Gynecology,Beijing Hospital,Beijing 100730,China)
出处
《中华糖尿病杂志》
CAS
CSCD
北大核心
2020年第7期474-479,共6页
CHINESE JOURNAL OF DIABETES MELLITUS
