妊娠期糖尿病孕妇血糖监测频率与围产结局的关系

Study on Relationship between Blood Glucose Monitoring Frequency of the Pregnant Women with Gestational Diabetes Mellitus and Perinatal Outcomes

目的探讨妊娠期糖尿病孕妇血糖监测与围产结局的关系。方法选择2008年1月—2011年1月在浙江大学医学院附属妇产科医院产前检查的妊娠期糖尿病孕妇197例。所有孕妇采用饮食指导结合运动锻炼控制血糖水平,必要时加用胰岛素治疗。根据孕妇自我血糖监测的频率分为每天监测4次组共40例(A组),隔天监测4次组共88例(B组),每周1天监测4次组共69例(C组)。比较分析3组血糖监测方式的依从性差异以及孕产妇并发症发生率。结果 B组和C组监测方式的依从性明显高于A组,差异有统计学意义(P<0.01)。C组孕产妇发生子痫前期、新生儿窒息、羊水过多、早产、新生儿低血糖、巨大儿和剖宫产率均高于A组和B组。而A组和B组各围产期并发症发生率差异无统计学意义(P>0.05)。结论经饮食调整和运动控制血糖水平的孕妇,可以隔天监测血糖水平,既能孕妇经济和精神负担,又能降低围产期并发症。采用胰岛素控制血糖的患者仍要每天监测,减少母婴并发症发生。

Objective To explore the relationship between blood glucose monitoring frequency of pregnant women with gestational diabetes mellitus（GDM） and perinatal outcomes.Methods 197 GDM pregnant women who took prenatal care at the Women＇ s Hospital School of Medicine,Zhejiang University,from Jan.2008 to Jan.2011 were recruited as research subjects.All recruited pregnant women were treated with diet therapy combined with physical exercise to control the level of blood glucose;insulin therapy was used if necessary.The pregnant women were divided into three groups,according to monitoring frequency of blood glucose.Group A including 40 cases were monitored four times every day,and group B（88 cases） were monitored four times every other day,while group C（69 cases） four times every week.The compliance of blood glucose monitoring and incidence of maternal complications were analyzed.Results Compliance of blood glucose monitoring in group B and C were significantly higher than those in group A（P 0.01）.Incidence of preeclampsia,neonatal asphyxia,polyhydramnios,premature birth,neonatal hypoglycemia,fetal macrosomia and caesarean section in group C were significantly higher than those in group A and B.There was no significant difference for incidence of perinatal complications in group A and B（P 0.05）.Conclusion The pregnant women,treated with diet therapy combined with physical exercise and monitor blood glucose levels every the other day,could reduce economy and mental stress as well as perinatal complications.Pregnant women with insulin therapy still need to control blood glucose every day in order to reduce the incidence of maternal and fetal complications.