摘要目的 探讨妊娠期糖尿病(GDM)孕妇的新生儿是否存在铁缺乏的状况.方法 前瞻性选择2008年6月至2011年10月在温州医学院附属第二医院住院治疗的64例GDM孕妇及其分娩的新生儿作为GDM组；同期71例健康孕妇及其分娩的新生儿作为对照组.检测两组新生儿脐血铁蛋白(SF)、血清转铁蛋白受体(sTfR)、促红细胞生成素(Epo)、血红蛋白(Hb)、血清胰岛素、血糖水平,并测量新生儿出生体质量(BW),计算年龄别体质量评分(WAZ,用中位数表示).同时检测两组孕妇分娩前空腹血清胰岛素(FINS)、空腹血糖(FPG)和糖化血红蛋白(HbAlc)水平.结果 GDM组新生儿脐血sTfR、Epo、血清胰岛素水平分别为(42±10) nmol/L、(56±41) U/L和(18±5)U/L,均明显高于对照组的(35±8)nmol/L、(41±43)U/L和(10±5) U/L,差异均有统计学意义(P＜0.05)；GDM组新生儿脐血SF为(60±36) μg/L,明显低于对照组的(146±38) μg/L,差异有统计学意义(P＜0.01)；GDM组新生儿BW及WAZ分别为(3615±538)g和0.558分,明显高于对照组的(3449±423)g和0.224分,差异均有统计学意义(P＜0.05)；GDM组新生儿脐血糖[(3.3±1.0) mmol/L]和Hb水平[(181±18) g/L]与对照组比较[分别为(3.0±0.8) mmol/L和(176±16) g/L],差异均无统计学意义(P＞0.05).GDM组孕妇分娩前FINS及HbAlc分别为(12.5±5.0) U/L和(6.5±0.7)％,均明显高于对照组的(10.9±4.3) U/L和(5.3±0.7)％,差异均有统计学意义(P＜0.05)；两组孕妇FPG分别为(5.3±1.2)和(5.0±1.0) mmol/L,两组比较,差异无统计学意义(P＞0.05).结论 GDM孕妇分娩的新生儿存在铁缺乏的状况.

abstractsObjective To investigate the iron status in the newborns of maternal gestational diabetes mellitus(GDM) women,and explore the mechanism of iron deficiency in these newborns.Methods From June 2008 to October 2011,64 GDM women (GDM group) and 71 healthy pregnant women (control group)who delivered in the Second Affiliated Hospital of Wenzhou Medical College and their newborns were studied prospectively.Serum ferritin (SF),serum transferrin receptor (sTfR),erythropoietin (Epo),haemoglobin (Hb),serum level of insulin and plasma glucose in cord blood was measured.The neonatal birth weight (BW) and birth weight Z Score(WAZ) was recorded.The concentrations of serum fasting insulin (FINS),fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c)were tested for all the women before delivery.Results In the GDM group,the cord blood sTfR,Epo and serum level of insulin was (42 ± 10)nmol/L,(56 ±41) U/L and(18 ± 5) U/L,respectively.While in the control group,these were(35 ± 8)nmol/L,(41 ± 43) U/L and (10 ± 5) U/L,respectively.The cord blood sTfR,Epo and serum level of insulin in the GDM group were significantly higher than those in the control group (P ＜ 0.05).The cord blood SF in the GDM group[(60 ±36) μg/L] was significantly lower than that of the control group[(146 ±38) μg/L,P ＜ 0.01].The neonatal BW and WAZ in the GDM group [(3615 ± 538) g and 0.558] were significantly higher than those in the control group [(3449 ± 423) g and 0.224,P ＜ 0.05].No significant difference was found in the cord blood plasma glucose and Hb between the GDM group[(3.3 ± 1.0) mmol/L and (181 ± 18) g/L] and the control group [(3.0 ± 0.8) mmol/L and (176 ± 16) g/L,P ＞ 0.05].The FINS and HbA1c of the GDM group[(12.5 ±5.0) U/L and (6.5 ±0.7)％] were significantly higher than those in the control group [(10.9 ± 4.3) U/L and (5.3 ± 0.7) ％,P ＜ 0.05].The FPG of the GDM group and the control group were (5.3 ± 1.2) and (5.0 ± 1.0) mmol/L,respectively,with no statistically significant difference (P ＞ 0.05).Conclusion Maternal GDM may related to the iron deficiency of the newborns.