【目的】动态观察大于胎龄儿（1arge for gestational age，LGA）体格发育的特点，给予医学干预，降低肥胖发生率，也为进一步制定有效的干预措施提供理论依据。【方法】将研究对象于O～2岁期间定时监测体重、身高，通过体质指数（body ...【目的】动态观察大于胎龄儿（1arge for gestational age，LGA）体格发育的特点，给予医学干预，降低肥胖发生率，也为进一步制定有效的干预措施提供理论依据。【方法】将研究对象于O～2岁期间定时监测体重、身高，通过体质指数（body mass index，BMI）衡量营养状况，计算肥胖率。【结果】LGA儿各时点的BMI值高于适于胎龄儿（appropriate for gestational age，AGA）（P〈O．05），变化规律一致，但LGA儿峰值提前，肥胖率增高（P〈O．01），干预后，LGA儿1年后的BMI值接近AGA儿（P〉O．05），峰值延迟，肥胖率下降。【结论】LGA儿肥胖发生率高，生后立即给予干预，体格发育可达正常水平，降低肥胖率。展开更多
Objectives: To evaluate our singlecenter, singleteam experience with induction of labor in pregnancies with suspected large for gestational age (LGA) fetuses. Study design: A retrospective casecontrolled design ...Objectives: To evaluate our singlecenter, singleteam experience with induction of labor in pregnancies with suspected large for gestational age (LGA) fetuses. Study design: A retrospective casecontrolled design was used. Nondiabetic patients with a suspected LGA fetus (estimated fetal weight ≥90th percentile) (group 1, n=135) were compared with healthy patients admitted for elective induction of labor for either postdate pregnancy or a subjective perception of decreased fetal movements in the presence of normal fetal heart monitoring and biophysical profile (group 2, n=326), and with healthy women with normal pregnancies and spontaneous onset of labor (group 3, n=574). Results: There were no betweengroup differences in maternal age, parity, number of prostaglandin E2(PGE2) tablets used, instrumental delivery rate or Apgar scores. The rate of cesarean section (CS) was significantly higher in the study group (33.3%) than in group 2 (17.8%, P=0.001) and group 3 (10.6%, P=0.004), although this difference disappeared when the multiparous women were analyzed separately (study group: n=58, 10.3%versus group 2: n=169, 7.7%and group 3: n=308, 7.8%, P=0.6). A logistic regression model (R2=0.385, P<0.001) was used to control for maternal and gestational age, nulliparity rate, number of PGE2 tablets used, birth weight, and diagnosis (group 1 versus group 2) as predictors of mode of delivery. On stepwise (forwardlikelihood) analysis, only nulliparity (odds ratio (OR) 10.0, 95%confidence interval (CI) 2.8-35.6, P< 0.001) and maternal age (OR 1.2, 95%CI 1.06-1.36, P=0.002) were independently and significantly associated with increased risk of CS. Conclusions: Induction of labor for suspected LGA fetuses, if performed at all, should be reserved for multiparous women.展开更多
The purpose of this study was to determine whether there is a difference in body composition and the factors that are associated with fat mass in the large-for -gestational -age infants of women with gestational diabe...The purpose of this study was to determine whether there is a difference in body composition and the factors that are associated with fat mass in the large-for -gestational -age infants of women with gestational diabetes mellitus compared with the large -for -gestational -age infants of women with normal glucose tolerance levels.Large for gestational age was defined as weigh t >90th percentile for gestational age,race,and sex on the basis of our popula-tion’s normative data.Anthropometric me asurements and /or total body electrical conductivity estimated body com-position that included fat mass,percent body fat,and lean body mass were obtained.Multiple stepwise regression was used to determine factors correlating with fat mass.Fifty cases of women with gestational diab etes mellitus and 52cases of women with normal glucose to lerance levels were evaluated.Infants of mothers with g estational diabetes mellitus had increased fat mass(662vs 563g;P =.02)and percent body fat(16.2%vs 13.5%;P =.002)but decreased lean body mass(3400vs 3557g;P =.0009),as compared with infants of mothers w ith normal glucose tolerance levels,despite similar b irth weights.Stepwise regression on all 102women showed ge stational age and a diagnosis of gestational diabetes m ellitus correlated with fat mass(r2 =0.11;P =.001).For gestational dia-betesmellitus alone,both gestatio nal age and fasting value of the oral glucose tolerance test co rrelated with fatmass and percent body fat(r 2 =0.33P=.0009and r 2 =0.26P =.005,respectively).Large -for -gestational -age infants of mothers with gestational diabetes mellitus have increased fat mass and decreased lean body mass compared with infants of mothers with normal g lucose tolerance lev-els.In gestational diabetes mellit us,gestational age and fasting value of the oral glucose tolerance test correlated best with fat mass.展开更多
文摘【目的】动态观察大于胎龄儿（1arge for gestational age，LGA）体格发育的特点，给予医学干预，降低肥胖发生率，也为进一步制定有效的干预措施提供理论依据。【方法】将研究对象于O～2岁期间定时监测体重、身高，通过体质指数（body mass index，BMI）衡量营养状况，计算肥胖率。【结果】LGA儿各时点的BMI值高于适于胎龄儿（appropriate for gestational age，AGA）（P〈O．05），变化规律一致，但LGA儿峰值提前，肥胖率增高（P〈O．01），干预后，LGA儿1年后的BMI值接近AGA儿（P〉O．05），峰值延迟，肥胖率下降。【结论】LGA儿肥胖发生率高，生后立即给予干预，体格发育可达正常水平，降低肥胖率。
文摘Objectives: To evaluate our singlecenter, singleteam experience with induction of labor in pregnancies with suspected large for gestational age (LGA) fetuses. Study design: A retrospective casecontrolled design was used. Nondiabetic patients with a suspected LGA fetus (estimated fetal weight ≥90th percentile) (group 1, n=135) were compared with healthy patients admitted for elective induction of labor for either postdate pregnancy or a subjective perception of decreased fetal movements in the presence of normal fetal heart monitoring and biophysical profile (group 2, n=326), and with healthy women with normal pregnancies and spontaneous onset of labor (group 3, n=574). Results: There were no betweengroup differences in maternal age, parity, number of prostaglandin E2(PGE2) tablets used, instrumental delivery rate or Apgar scores. The rate of cesarean section (CS) was significantly higher in the study group (33.3%) than in group 2 (17.8%, P=0.001) and group 3 (10.6%, P=0.004), although this difference disappeared when the multiparous women were analyzed separately (study group: n=58, 10.3%versus group 2: n=169, 7.7%and group 3: n=308, 7.8%, P=0.6). A logistic regression model (R2=0.385, P<0.001) was used to control for maternal and gestational age, nulliparity rate, number of PGE2 tablets used, birth weight, and diagnosis (group 1 versus group 2) as predictors of mode of delivery. On stepwise (forwardlikelihood) analysis, only nulliparity (odds ratio (OR) 10.0, 95%confidence interval (CI) 2.8-35.6, P< 0.001) and maternal age (OR 1.2, 95%CI 1.06-1.36, P=0.002) were independently and significantly associated with increased risk of CS. Conclusions: Induction of labor for suspected LGA fetuses, if performed at all, should be reserved for multiparous women.
文摘The purpose of this study was to determine whether there is a difference in body composition and the factors that are associated with fat mass in the large-for -gestational -age infants of women with gestational diabetes mellitus compared with the large -for -gestational -age infants of women with normal glucose tolerance levels.Large for gestational age was defined as weigh t >90th percentile for gestational age,race,and sex on the basis of our popula-tion’s normative data.Anthropometric me asurements and /or total body electrical conductivity estimated body com-position that included fat mass,percent body fat,and lean body mass were obtained.Multiple stepwise regression was used to determine factors correlating with fat mass.Fifty cases of women with gestational diab etes mellitus and 52cases of women with normal glucose to lerance levels were evaluated.Infants of mothers with g estational diabetes mellitus had increased fat mass(662vs 563g;P =.02)and percent body fat(16.2%vs 13.5%;P =.002)but decreased lean body mass(3400vs 3557g;P =.0009),as compared with infants of mothers w ith normal glucose tolerance levels,despite similar b irth weights.Stepwise regression on all 102women showed ge stational age and a diagnosis of gestational diabetes m ellitus correlated with fat mass(r2 =0.11;P =.001).For gestational dia-betesmellitus alone,both gestatio nal age and fasting value of the oral glucose tolerance test co rrelated with fatmass and percent body fat(r 2 =0.33P=.0009and r 2 =0.26P =.005,respectively).Large -for -gestational -age infants of mothers with gestational diabetes mellitus have increased fat mass and decreased lean body mass compared with infants of mothers with normal g lucose tolerance lev-els.In gestational diabetes mellit us,gestational age and fasting value of the oral glucose tolerance test correlated best with fat mass.
