Relationship between speed of body mass growth and other relative indexes in GDM patients and the growth and development of neonatal body / 中国综合临床

ABSTRACT

Objective To investigate the influence of the speed of body mass growth in gestational diabetes mellitus(GDM)patients on the growth and development of neonatal body.Methods All of the one hundred and thirty-three pregnant women with GDM diagnosed by OGTT and hospitalized in Suining Cental Hospital for delivery were involved in the study.heir fasting plasma glucose,total cholesterol and HbAlc during a week before delivery and the speed of body mass growth at 3 weeks before childbirth were recorded.According to the body length at 1 week after delivery and body quality standards,all infants were divided into the good group and the poor group.Then,independent samples t test analysis was applied to analyze the effect of the fasting plasma glucose,total cholesterol,HbAlc and the speed of body mass growth in mother on the growth and development of neonatal body in two groups.The influence of factors which has statistically significant on neonatal body was analyzed by Multiple factors Logistic regression analysis and the association between those factors and the growth and development of neonatal body was showed on scatter diagram.Meanwhile,ROC curve was used to evaluate The effect degree of various factors on the growth and development of newborns and their best diagnostic points were calculated.Results The fasting plasma glucose((7.44 ± 2.27)mmol/L),total cholesterol((6.05±1.57)mmol/L),HbAlc((5.18±0.53)%)and the speed of body mass growth at 1st week ((0.35±0.20)kg/w),2nd week((0.28±0.21)kg/w)and 3rd week((0.36±0.18)kg/w)before delivery in good group were lower than those in the poor group((8.61±3.25)mmol/L,(6.78±1.84)mmol/L,(5.62 ±0.76)%,(0.71± 0.16)kg/w,(0.84 ± 0.11)kg/w,(0.76 ± 0.13)kg/w))(t=2.222,2.413,5.575, 11.617,20.183,14.321,P<0.05).Multivariate logistic regression analysis showed that the content of HbAlc (OR=2.391),the speed of body mass growth at 2nd week before delivery(OR=3.045)and the speed of body mass growth at 1st week before delivery(OR=4.081)had significant effect on the growth and development of neonatal body and the speed of body mass growth at 1st week before delivery had the greatest influence(P<0.05); There were negative correlation among HbAlc,neonatal length and the increase in body mass(r=-0.490,-0.481,P<0.05); at 2nd week before delivery,HbAlc,neonatal length and the increase in body mass were negatively correlated(r=-0.353,-0.396,P,<0.05); at 1st week before delivery,HbAlc,neonatal length and the increase in body mass were negatively correlated(r=-0.495,-0.474,P,<0.05).At the same time,ROC analysis showed that the AUC of HbAlc was 0.566 while the speed of body mass growth at 1st week and 2nd week before delivery were 0.723 and 0.796,respectively and the AUC of the speed of body mass growth at 1st week before delivery was the highest.Conclusion The speed of body mass growth at 1st week before delivery can slow down the increase of neonatal length and body mass,and can be used as a therapeutic target for the clinical control of neonatal dysplasia in GDM patients.