妊娠期糖代谢异常孕妇妊娠结局的前瞻性对照研究

A Prospective case-control study of pregnant outcomes in women with abnormal gestational glucose tolerances

目的:探讨妊娠期糖代谢异常(GDM和GIGT)孕妇的发病情况以及妊娠结局。方法:采用前瞻性对照研究的方法,将太原市妇幼保健院2005年6月—2007年8月被诊断为糖代谢异常孕妇118例作为研究组,同时选取OGTT正常孕妇120例为对照组,比较两组孕妇的母儿并发症及妊娠结局。结果:妊娠期糖代谢异常组和对照组孕妇的平均年龄、孕前体重指数及孕期体重增长两组比较,均P<0.05;糖代谢异常组高龄、有不良孕产史、患有多囊卵巢综合症及有糖尿病家族史的孕妇明显高于对照组;糖代谢异常组巨大儿发生率、剖宫产率以及新生儿高胆红素血症的发生率明显高于对照组;糖尿病母儿的严重不良结局来自于产前的漏诊。结论:妊娠期糖代谢异常影响母儿结局,如果所有孕妇能得到GDM的筛查和规范化的管理,有可能预防或减少产伤的发生及其他母儿并发症。

Objective：To investigate pregnant outcomes in women with GDM ＆. GIGT. Methods..A prospective case-control study was performed in 118 women with abnormal gestational glucose toleraance and 120 cases of normal oral glucose tolerance test （OGTT） as control recruited from Jun 2005 to Aug 2007 in Taiyuan Maternal and Infant Health Care Hospital in order to compare the complications of pregnant women and infants between study and control groups. Results ：Average age of women,Pre-pregnancy body mass index,gestational weight getting were significantly higher in GDM/GIGT group than those of control group（P〈0.05）. Age≥30,a family history of diabetes mellitus ,a history of bad pregnant outcome,PCOS were significantly higher in GDM/GIGT group than those of control group（P 〈0. 05）. The rate of macrosomia,cesarean section and neonatal hyperbilirubinemia in GDM/GIGT group was signifi- cantly higher than those in control group. The severe complications of infants and women with abnormal geststional glucose tolerances resulted from non-diagnose to GDM/GIGT before delivery. Conclusion ：Abnormal gestational glucose tolerances affected the complications of maternal and fetal outcomes,which can be decereased by strict diagnosis and regular management.