| Objectives:To explore the effects of pre-pregnancy body mass index(BMI),gestational weight gain(GWG)and levels of maternal blood lipid,Vaspin,and Visfatin on physical development of neonates in gestational diabetes mellitus(GDM)and healthy women.Methods:Data of 1108 pregnant women(308 GDM women and 800 non-GDM pregnancy women)and their neonates were collected from November 2015 to May 2016 at the department of obstetrics,the Second Affiliated Hospital of Zhengzhou University.The venous serum samples(227)were collected from 96 GDM subjects and 131 non-GDM women before delivery.The levels of total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),triglyceride(TG),Vaspin,and Visfatin were measured.The subjects were divided into GDM group and control group.Based on the pre-pregnancy body mass index(BMI),they were further divided into low weight,normal weight,and overweight/obesity groups.Based on gestational weight gain(GWG),they were divided into low,normal and high GWG groups.Neonates were divided into low birth weight,normal birth weight and macrosomia according to their birth weight.Chi-square test,t-test,analysis of variance,binary and multinomial logistic regression,Pearson or Spearman correlation analysis were used to analyze the relationships between pre-pregnancy BMI,GWG and birth weight,body length,chest circumference,head circumference and Ponderal index of neonates in GDM group and control group.The levels of serum TC,HDL-C,LDL-C,TG,Vaspin,and Visfatin of prenatal venous serum between GDM group and control group were compared,and their effect on neonatal growth parameters were analyzed.Results:(1)The birth weight,chest circumference,head circumference and Ponderal index of neonates in GDM group were larger than that in control group(P<0.05).(2)GDM was a risk factor for macrosomia(OR=2.307,95%CI: 1.470~3.622)and tended to have larger neonatal Ponderal index(OR=1.617,95%CI: 1.117~2.341).(3)The Ponderal index of neonates was higher in pre-pregnant overweight/ obesity group than that in normal pre-pregnant weight group(P<0.05)in GDM with normal GWG group.The birth weight of neonates in pre-pregnant low weight maternal group was lower than that in normal weight group(P<0.05)in non-GDM group with normal GWG.The circumferences of neonatal chest and head in low pre-pregnant weight group were smaller than those in normal pre-pregnant weight and overweight/obesity groups(P<0.05)in non-GDM group with high GWG.Multinomial logistic regression showed that the lower pre-pregnancy BMI was,the shorter body length of neonates(OR=2.214,95%CI: 1.169~4.192).Pre-pregnant overweight/obese women had high risk to deliver macrosomia baby(OR=1.956,95%CI: 1.145~3.342)and tended to have larger neonatal Ponderal index(OR=1.710,95%CI: 1.094~2.671).(4)The birth weight and Ponderal index of neonates were lower in low GWG group than that in high GWG group(P<0.05)in GDM group of normal pre-pregant weight group.The birth weight and chest circumference of neonates in low and normal GWG groups were lower than that in high GWG group in non-GDM group with normal pre-pregnant weight group(P<0.05).Multinomial logistic regression showed that poorer GWG tended to have smaller neonal head circumference(OR=1.888,95%CI: 1.186~3.004).(5)The maternal serum level of TG was positively associated with neonatal chest circumference in both GDM and non-GDM groups(r=0.203,P=0.047;r=0.288,P=0.001).(6)The maternal serum levels of Vaspin and Visfatin were correlated neither with neonatal birth weight,and length,nor circumferences of chest and head,as well as Ponderal index of neonates(P>0.05).Conclusions:(1)GDM is the risk factor of having macrosomia and tends to have larger neonatal Ponderal index,but it has no effct on neonatal body length and head circumference.(2)Pre-pregnant overweight/obesity is the risk factor of having macrosomia and tends to have larger neonatal Ponderal index.The lower pre-pregnancy BMI tends to have shorter body length of neonates.Poorer GWG tends to have smaller neonatal head circumference.(3)The materal serum TG level is positively associated with neonatal chest circumference in both GDM and non-GDM groups.The levels of maternal serum Vaspin and Visfatin are not significantly associated with neonatal birth weight,length,circumferences of head and chest,as well as the Ponderal index. |
