关键词: 糖尿病, 妊娠, 巨大胎儿, 糖尿病饮食, 超重

Abstract: Objective　To investigate the associations of gestational diabetes mellitus（GDM） with neonatal birth weight and macrosomia under the circumstances of proper management and treatment.Methods　The medical records of 1 937 pregnant women who had regular prenatal examinations in Beijing Obstetrics and Gynecology Hospitals,Capital Medical University from August 2011 to February 2012 were analyzed retrospectively.Data,including maternal age,gestational week,height,pre-pregnancy weight,weight of mid（13-27 weeks of gestation），late（from 28 weeks of gestation to deliver） and before pregnancy,neonatal birth weight and gender,were recorded.Pregnant women were divided GDM group（n=214） or normal glucose tolerance（NGT） group（n=1 723） according to their results of OGTT at 24-28 weeks of gestation.Women,who diagnosed with GDM,received proper management and treatment,including individualized nutritional regimen,recommendation of physical activity,self-monitoring of blood glucose,and daily recording.Specific feedback was provided according to their eating habits,physical activity,weight gain,and fetal growth.Insulin treatment was provided when necessary.Multivariable Logistic regression was conducted to analyse the risk factors of macrosomia.Results　Maternal age,pre-pregnancy BMI,and rate of overweight/obesity were higher,whereas gestational week,total weight gain during pregnancy,and weight gain during mid and late pregnancy were lower in the GDM group than in the NGT group（P<0.05）.No statistical difference in neonatal birth weight,incidence of macrosomia and low birth weight infants was observed between the two groups（P>0.05）.Multivariable Logistic regression analyses showed that the risk of macrosomia was associated with gestational weeks〔OR=2.270,95%CI（1.615,3.191）〕,pre-pregnancy overweight/obesity〔OR=2.155,95%CI（1.322,3.514）〕,and male newborns〔OR=1.626,95%CI（1.157,2.283）〕,but was not associated with GDM（P>0.05）.Conclusion　GDM is not an independent risk factor for macrosomia after proper management and treatment,while pre-pregnancy overweight/obesity is still a risk factor of macrosomia.

Key words: Diabetes,gestational, Fetal macrosomia, Diabetic diet, Overweight