The Analysis On Value Of Glycometabolism Index During Pregnancy To Predict Unexplained Small For Gestational Age

Chapter I:Clinical analysis of factors related to the unexplained SGAObjectives:To study of factors related to the unexplained SGA and to analysis the relationship betweenunexplained SGA and maternal blood glucose.Methods:Medical records which deliveried in Zhuhai People’s Hospital from January2014toFebruary2008were collected in this study. According to the neonatal birth weight we dividedthese medical records into SGA group and AGA group.Results:1. The two groups of pregnant women had no significant difference on delivery times,height, weight gain during pregnancy (P>0.05), but had statistical difference on maternalage, gravidity, pre pregnancy and BMI(P<0.05). Degree level of the two groups has nosignificant difference(P>0.05).Two groups of the newborns had no significant difference onthe general situation (P>0.05).2. Two groups of pregnant women with OGTT results shows: there was significantdifference in fasting blood glucose (P<0.05), there was no statistical difference on OGTT1hours and2hours blood glucose (P>0.05).Conclutions:1. SGA are more susceptible on these women:low pre pregnancy BMI and have multiplepregnancy.2. Lower fasting plasma glucose in pregnant women can affect fetal on growth anddevelopment.Chapter II:The changes of maternal insulin sensitivity with unexplained SGA and theprediction of SGAObjectives: To explore the possible relationship between the indexes of glucose metabolism and thecauses of unexplained SGA and to evaluate the ability of these parameters to predict unexplainedSGA. Then,established a prediction model to predict SGA.Methods:1. Pregnant women with unexplained SGA were selected, according to the number ofSGA group，random seleceted the same number of pregnant women as group AGA whodelivered coeval but the neonatal birth weight according with gestational age.2. Blood glucose levels and insulin levels of the two groups were test and QUICKI andOGIS were calculate.Results:1. Fasting blood glucose and fasting insulin of the two groups had statistically significantdifference (P<0.05), blood glucose and insulin levels after oral glucose1hours,2hourswere not statistically significant (P>0.05), index of insulin sensitivity QUICKI and OGISwere statistically different(P<0.05).2. Bayes discriminant equation: Y1=3.951(OGIS)+5.777(QUICKI)-6.863(fastinginsulin)-1.746(2hours insulin)+2.458(fasting blood glucose)-11.097, Y2=1.401(OGIS)+3.691(QUICKI)-3.823(fasting insulin)-1.383(2hours) insulin)+3.971(fasting bloodglucose)-8.218Conclutions:1. Elevated insulin sensitivity seems to be a factor causing unexplained SGA;2. The prediction model established in this study has a high predictive value on theoutcome of pregnancy.