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目的探讨浙江台州地区巨大儿发生的危险因素及出生后1年内生长发育变化。方法选取该院妇产科出生,并在儿科门诊随访至1周岁的婴儿为研究对象,巨大儿48例为巨大儿组,同期分娩的正常体重新生儿86例为正常组。观察巨大儿组孕妇的特征以及巨大儿从出生到1周岁的头围、体重变化,并与正常出生体重儿进行比较。结果巨大儿组孕妇血糖、血脂水平和剖宫产率均显著高于正常组,差异有统计学意义(P<0.05或P<0.01);两组孕妇的血胆固醇水平、学历、年龄、喂养方式及新生儿性别差异无统计学意义(均P>0.05)。巨大儿组男童头围在1月龄、3月龄均显著高于正常组,且3月龄头围的增长速率显著低于正常组,差异有统计学意义(P<0.01),而6月龄、8月龄、1周岁时头围大小及增长速率差异无统计学意义(均P>0.05)。巨大儿组各年龄段男童或女童的体重、女童的头围均显著高于正常组,差异有统计学意义(P<0.05或P<0.01),男童体重的增长速率在3月龄时显著低于正常组,差异有统计学意义(P<0.05),而1月龄、6月龄、8月龄、1周岁年龄段两组的体重增长速率差异无统计学意义(均P>0.05);女童的体重增长速率、头围的增长速率与正常组比较差异无统计学意义(均P>0.05)。巨大儿组1周岁时血红蛋白水平显著高于正常组,差异均有统计学意义(P<0.05);6月龄时两组差异无统计学意义(P>0.05)。两组血小板水平在6月龄、1周岁时差异均无统计学意义(均P>0.05)。结论影响台州地区巨大儿出生的危险因素与孕期高血糖、高血脂水平有关,与孕妇的胆固醇、年龄、文化程度无关。1岁内巨大儿头围、体重的生长速率存在性别差异,男童出生后前3个月有减速现象,女童无变化。
Objective To investigate the risk factors of macrosomia in Taizhou, Zhejiang Province and the changes of growth and development within one year after birth. Methods The obstetrics and gynecology was selected in this hospital. The infants who were followed up to 1 year old in pediatric outpatient department were enrolled in this study. 48 cases of giant macrosomia were macrosomia group, and 86 cases of normal weight neonates were delivered as normal group. Observe the characteristics of pregnant women in the macular group and the head circumference, body weight of macrosomia from birth to 1 year of age, and compare with normal birth weight. Results The blood glucose level, blood lipid level and cesarean section rate of pregnant women in Giant group were significantly higher than those in normal group (P <0.05 or P <0.01). The levels of blood cholesterol, education, age, Neonatal gender differences were not statistically significant (all P> 0.05). The head circumference of boys in huge children group was significantly higher than that of normal group at 1 month, 3 months and 3 months, and the growth rate of head circumference at 3 months was significantly lower than that of normal group (P <0.01) There was no significant difference in head circumference, size and growth rate between months old, 8 months old and 1 year old (all P> 0.05). The weight of boys and girls in each age group and the head circumference of girls in the giant children group were significantly higher than those in the normal group (P <0.05 or P <0.01). The growth rate of boys’ weight at the age of 3 months (P <0.05), while there was no significant difference in the rate of weight gain between the two groups at 1 month, 6 months, 8 months and 1 year (all P> 0.05 ). There was no significant difference in the growth rate of weight gain and head circumference between the girls and the normal group (all P> 0.05). The hemoglobin level in the macrosomia group was significantly higher than that in the normal group at 1 year of age (P <0.05). There was no significant difference between the two groups at 6 months of age (P> 0.05). There was no significant difference in platelet levels between the two groups at 6 months and 1 year (all P> 0.05). Conclusion The risk factors affecting the birth of giant children in Taizhou are related to the levels of hyperglycemia and hyperlipidemia during pregnancy, but not to the cholesterol, age and education level of pregnant women. There is a gender difference in the growth rate of the body weight in a 1-year-old man. The boy has a deceleration in the first 3 months of life and no change in the girl.