妊娠合并糖代谢异常与胎儿畸形的关系

Relationship between pregnancies complicated by abnormal glucose metabolism and congenital neonatal abnormalities

目的：探讨妊娠合并糖代谢异常（包括妊娠期糖代谢异常和糖尿病合并妊娠）与胎儿畸形的关系。方法：分析2003年6月2007年6月在我院分娩6194例产妇的临床资料,按50g葡萄糖筛查和75g OGTT检查结果分为GCT（＋）、GIGT、GDM和DM4类,分别统计4类产妇分娩新生儿中畸形数和畸形类型。结果：DM合并妊娠胎儿畸形率显著高于血糖正常妇女（P〈0.05）,GDM患者胎儿畸形率与血糖正常妇女比较胎儿畸形率无显著差异（P〉0.05）,GDM患者胎儿心脏畸形发生与血糖正常妇女相比无增加（P〉0.05）。发生胎儿畸形的血糖异常妇女糖化血红蛋白值升高。结论：DM合并妊娠胎儿畸形率升高,GDM孕妇畸胎率与正常妇女比较无明显变化。

Objective：To explore the relationship between pregnancies complicated by abnormal glucose metabolism（including gestational abnormal glucose metabolism and pregnancies with pre-existing diabetes） and congenital neonatal abnormalities.Methods：Clinical data of 6194 pregnant women was analyzed for the frequence and patterns of congenital neonatal abnormalities from June 2003 to June 2007.According to the results of the 50g glucose challenge test and 75g oral glucose tolerance test,they were divided into four groups：positive glucose challenge test group（GCT）,gestational impaired glucose test（GIGT） group,gestational diabetes mellitus（GDM） group and pregnancies with pre-existing diabetes group.Results：The incidences of congenital anomalies in women with pre-existing diabetes were significantly higher than that in normal pregnant women（P〈0.05）.No significant difference was found in the neonatal congenital abnormity rate in GDM population and that in women with normal glucose level（P〉0.05）.The incidence of the neonatal cardiac defects in GDM women was not significantly higher than that in women with normal glucose status（P〉0.05）.The value of glycosylated hemoglobin increased in women with abnormal glucose level accompanying with neonatal abmormality.Conclusion：The incidences of congenital abnormalities in women with pre-existing diabetes are significantly higher than that in women with normal glucose status.And compared with women with normal glucose level,there is no difference in GDM women in neonatal congenital abnormity rate.