糖尿病母亲婴儿的生后管理及发育随访

Perinatal management and the follow-up of infant of gestational diabetes mother.

【目的】探讨如何降低糖尿病母亲婴儿(infantofgestationaldiabetesmother,IDM)的围生期并发症及对婴儿期体格及智能发育的影响,为临床有效防治提供科学依据。【方法】对172例IDM进行了系统管理(IDM1组),与97例非系统管理IDM(IDM2组)进行了比较,观察其围生期并发症,对其体格及智能发育进行了随访。【结果】IDM出生体重与母亲孕期血糖控制水平有关;IDM1组围生期总的并发症明显低于IDM2组(P<0.05);其中以低血糖降低明显(P<0.001);IDM的体格发育随访,巨大儿组的体及体质指数(bodymassindex,BMI)一直高于正常体重组。随访发育商(developingquotient,DQ)显示有并发症组总的DQ值一直低于无并发症组,部分月龄、部分能区差异有显著性(P<0.05)。【结论】IDM母亲孕期控制血糖,其婴儿出生后进行系统管理,可减少围生期并发症的发生,对婴儿近期体格和智能发育有一定影响,远期发育影响有待于进一步研究。

【Objective】 To study how to reduce perinatal complication of the infant of gestational diabetes mother（IDM）, and to evaluate the physical and mental development of IDM. 【Method】 Perinatal complication as well as the growth and development of 172 cases IDM under systematic management （Group Ⅰ） had been compared with 97 cases IDM of non-systematic management （Group Ⅱ）. 【Results】 The incidences of complications were significantly lower in group Ⅰ （P〈0.05）, especially in hypoglycemia （P〈0.001）. Boby weight and body mass index （BMI） of macrosomia were continuously higher than those of non-macrosomia babies between two groups. Developing quotient （DQ） of IDM in follow-up was lower than that of normal control group. DQ of complication group was lower than that of the non-complication group. 【Conclusion】 The IDM can reduce the complication in newborn by controlling the plasma glucose of the gestational diabetes mellitus （GDM） in pregnancy and managing systematically. The complication may effect the mental development of the infants in future.