新妊娠期糖尿病诊断标准与围生期母儿结局分析

Perinatal Outcome of Gestational Diabetes Mellitus by New Diagnostic Criteria

目的:采用新的妊娠期糖尿病诊断标准,结合孕期体重管理和膳食指导,加强母儿监护后,分析妊娠期糖尿病的围生期母儿结局。方法:回顾性分析2011年1月1日至2011年8月13日在第三军医大学附属西南医院妇产科分娩的539例妊娠期糖尿病孕妇(A组)与同期539例低危孕妇(B组)的围生期结局。将孕产妇与妊娠糖代谢异常相关的并发症、分娩方式及围生儿并发症进行对照分析。结果:采用妊娠期糖尿病新诊断标准后,产科分娩人群中妊娠期糖尿病孕妇占17.71%,经过妊娠期糖尿病产科高危门诊健康管理,应用胰岛素的孕妇占妊娠期糖尿病孕妇的7.79%。A、B两组羊水过多、羊水过少、产后出血、新生儿窒息、新生儿低血糖、早产、新生儿肺炎、新生儿黄疸差异无统计学意义(P>0.05);胎膜早破、羊膜腔感染、巨大儿、低体重儿差异有统计学意义(P<0.05)。结论:妊娠期糖尿病采用新的诊断标准,结合孕期体重管理和膳食指导,母儿并发症得到有效的控制。

Objective ：To analyze the perinatal outcome of gestational diabetes mellitus（GDM） using the new diagnostic criteria, combined with weight management and dietary guidance during pregnancy, and strengthen the work of maternal and infant care. Methods：539 GDM pregnant women （study group） and 539 low-risk pregnant women （control group） who delivered in Southwest Hospital during January 1,2011 and August 13,2011 ,were enrolled into this study. The perinatal outcomes, including maternal complication- sassociated with abnormal glucose metabolism during pregnancy, mode of delivery and neonatal complica- tions were compared. Results：The percentage of GDM patients was 17.71% by the new GDM diagnostic criteria. After the clinic health care, the pementage of insulin use was 7.79% in GDM pregnant women. There were no significant differences of incidence of polyhydramnios, oligohydramnios, postpartum hemorrhage, neonatal asphyxia, neonatal hypoglycemia, preterm labor, neonatal pneumonia and jaundice between the study group and the control group i P 〉0.05）. While there were significant differences of incidence of prema- ture rupture of membrane, intra-amniotic infection, fetal macrosomia, low-birth weight between the two groups （P 〈0.05 ）. Conclusions：The perinatal complications can be controlled appropriately when using the new diagnostic criteria for gestational diabetes mellitus,combined with weight management and dietary guidance.