妊娠期糖尿病血糖水平与不良妊娠结局的关系

Association between gestational diabetes meUitus and adverse pregnancy outcomes

目的探讨有效控制血糖水平对减少妊娠期糖尿病母儿并发症及不良妊娠结局的重要意义。方法对血糖得到有效控制（空腹血糖〈5．8mmol/L和／或餐后2小时血糖〈6．7mmol／L）的妊娠期糖尿病孕妇80例（A组）与血糖控制不满意（空腹血糖≥5．8mmol/L和／或餐后2小时血糖≥6．7mmol/L）的妊娠期糖尿病孕妇39例（B组）和正常孕妇80例（C组）的孕、产及产褥期相关并发症及胎儿、新生儿并发症进行比较分析。结果A组妊娠期高血压疾病、早产、剖宫产、产后出血、巨大儿、胎儿窘迫的发生率均显著低于B组（X^2值分别为6．75、8．48、7。85、5．04、10．22、11。12，均P〈0．05）。A组仅羊水过多发生率高于c组（X^2=4．24，P〈0．05）。B组的妊娠期高血压疾病、羊水过多、早产、剖宫产、产后出血、巨大儿、胎儿生长受限、胎儿窘迫发生率均显著高于c组（X^2值为7．08-17．52之间，均P〈0．05）。结论加强妊娠期糖尿病的管理，控制妊娠期糖尿病孕妇血糖水平，可有效降低妊娠期糖尿病的并发症和不良妊娠结局的发生。

Objective To explore the significance of controlling blood sugar level on reducing the perinatal complications of gestational diabetes mellitus（GDM） and adverse pregnancy outcomes. Methods Group A was 80 pregnant women with GDM, whose blood sugar was well controlled （fasting blood glucose 〈 5.8mmol/L and/or 2h postprandial blood glucose 〈 6.7mmol/L）. Group B included 39 GDM pregnant women whose blood sugar was not well controlled （fasting blood glucose ≥5.8mmol/L and/or 2h postprandial blood glucose ≥ 6.7mmol/L）. Group C was 80 normal pregnant women. Maternal and perinatal complications were compared among the above three groups. Results In group A the prevalence of hypertensive disorders in pregnancy （ HDIP）, preterm birth, cesarean section delivered, postpartum hemorrhage, macrosomia, fetal distress was significantly lower than that in group B（X^2 was 6.75, 8.48, 7.85, 5.04, 10.22 and 11.12 respectively, all P 〈0.05）. Compared with group C, the prevalence rate of polyhydramnios in group A was higher（X^2 =4.24, P 〈 0.05）. Compared with that in group C, the prevalence rate of HDIP, polyhydranmios, preterm birth, cesarean section, postpartum hemorrhage, macrosomia, fetal growth restriction, fetal distress in group B was notably higher（X^2 was in the range of 7.08 - 17.52, all P 〈0.05 ）. Conduslon Strengthening the management of GDM and controlling blood sugar of pregnant women with GDM can effectively reduce the complicafions and adverse pregnancy outcomes.