| ObjectiveThis study was conducted to investigate the correlation between triglyceride and plasma glucose index(Ty G),platelet lymphocyte ratio(PLR)and birth weight of newborns delivered with gestational diabetes mellitus(GDM).The aim of this study is to explore the independent risk factors affecting the birth weight of newborns,to provide clinical reference for the rational management of pregnant women with GDM,to reduce the risk of delivering a large baby,and to further improve maternal and infant outcomes and long-term prognosis.MethodsA total of 236 pregnant women with GDM delivered in the obstetrics department of Qingdao Municipal Hospital from September 2018 to September 2022 were retrospectively analyzed,and their basic data such as age,height,weight,week of delivery,gestational age,gestational age and number of deliveries were collected,as well as fasting blood glucose(TBG),triglycerides(TG),total cholesterol(TC),platelet count and lymphocyte count in mid and late pregnancy.(TG),total cholesterol(TC),platelet count,lymphocyte count,etc.The Ty G index,PLR and pre-pregnancy body mass index(BMI)were calculated according to the formula,and the birth weight of the newborn was also recorded.According to whether the birth weight of the newborns was ≥4000g,they were divided into a group of massive babies(99 cases)and a group of non-massive babies(137 cases).The correlation between mid-and late-pregnancy Ty G index,PLR and the birth weight of newborns delivered in GDM patients was analysed to further assess whether they could be used as predictors of delivery of giant babies in GDM patients.SPSS26.0 statistical software was applied for statistical analysis.Parameters conforming to a normal distribution were expressed as mean ± standard deviation,and comparisons between group means were made using the independent samples t-test.Variables with P < 0.05 were selected for inclusion in the logistic regression analysis for independent risk factors associated with delivery of a large baby in pregnant women with GDM.The ROC curve was used to assess the predictive value of the independent risk factors and the combined factors for the delivery of a large baby in pregnant women with GDM,with P < 0.05 being considered a statistically significant difference.General information was compared,and the effect of whether or not to deliver a huge baby was used as the dependent variable,and the Ty G index,PLR and pre-pregnancy BMI in mid and late pregnancy were used as independent variables,and their effect on delivering a huge baby with GDM was analysed using univariate and multi-factor logistic regression.Subject work characteristic(ROC)curves were plotted to analyse the predictive value of Ty G index on the delivery of a huge baby in GDM patients.Results(1)Pre-pregnancy BMI,mid-and late-pregnancy fasting glucose,triglycerides,platelet count,Ty G index and PLR were all higher in the gigantic group than in the non-gigantic group,and the differences were statistically significant(P < 0.05);the differences in age at delivery,total cholesterol and week of pregnancy were not statistically significant(P > 0.05);the rates of caesarean section and neonatal hypoglycemia were higher in the gigantic group than in the control group,and the differences were statistically significant(P < 0.05).The incidence of cesarean section and neonatal hypoglycemia were higher in the giant group than in the control group,and the difference was statistically significant(P > 0.05).(2)Univariate Logistic regression analysis showed that pre-pregnancy BMI,Ty G index,PLR,platelet count and triglyceride were all risk factors for giant baby delivery in GDM patients(P < 0.05).(3)The results of Logistic regression analysis showed that pre-pregnancy BMI and Ty G index in the middle and late pregnancy were independent influencing factors of macrogenesis in GDM patients(P < 0.05).(4)The results of the ROC curve showed that the area under the ROC curve for mid-to late-pregnancy Ty G index was 0.643,(95% CI: 0.571-0.710,P < 0.01),1.988 was the best cut-off value for mid-to late-pregnancy Ty G index,with a sensitivity of 65.1% and a specificity of 72.3%.The area under the curve of pre-pregnancy BMI level for delivery of a large baby was 0.670,(95% CI: 0.601-0.740,P < 0.01),24.41 was the best cut-off value,with a sensitivity of 70.7% and a specificity of 55%.The area under the ROC curve was 0.694,(95%CI: 0.626-0.762,P < 0.01),with a sensitivity of 79.7% and a specificity of 52% for the two combined predictions.Conclusion1.A high level of Ty G index has a good predictive value for the delivery of a large baby,and is more sensitive when combined with pre-pregnancy BMI to predict the incidence of large babies.2.For pregnant women who have been diagnosed with gestational diabetes,strict control of blood glucose and lipid levels should be carried out in the middle and late stages of pregnancy to reduce the incidence of perinatal complications in both mother and baby. |
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