妊娠期糖尿病的孕期管理与母婴结局的关系

Management mode of gestational diabetes mellitus and pregnant outcome of mothers and babies

目的探讨妊娠期糖尿病的孕期管理与母婴结局的关系。方法选择2008年1月至2011年9月产检分娩确诊妊娠期糖尿病的患者118例。将孕期进行系统管理、血糖控制良好的孕妇78例列为干预研究组,将未进行有效规范管理、血糖控制不佳的孕妇40例列为干预对照组。同期随机抽取100例血糖正常的分娩孕妇作为正常对照组。分析比较3组孕妇的剖宫产率、妊娠并发症、巨大儿发生率等母婴结局关系。结果干预研究组的胎膜早破、早产、妊娠期高血压、胎儿窘迫、巨大儿、剖宫产率均低于干预对照组,差异有统计学意义(P<0.05),而干预研究组与正常对照组比较无统计学差异(P>0.05)。结论做好妊娠期糖尿病孕期系统规范化管理,可以有效控制血糖,明显降低母婴并发症的发生,改善母婴结局,甚至达到正常孕妇水平。

Objective To explore the management mode of gestational diabetes mellitus （GDM） and pregnant outcome of mothers and babies, and to provide the basis for shaping the intervention strategy, Methods One hundred and eighteen cases of GDM were selected from January ：2008 to September 2011, among of them 78 pregnant women （intervention group） were given diet and exercise guidance, insulin injection was given when necessary and the mothers and fetuses were monitored and given obstetric intervention, other 40 pregnant women who received only routine examination were taken as interventional control. One hundred normal pregnant women who delivered in our hospital during above mentioned period were taken as normal control. Results The incidences of hypertension, premature rupture of membranes, premature delivery, fetal distress, macrosomia and cesarean section in intervention group were significantly lower than those in intervention control group （ P 〈0.05 ） ; however, there were no differences in these incidences between intervention group and normal control group （ P 〉 0.05 ）. Conclusion The incidence of complications among maternal and child is significantly decreased and even close to the level of normal pregnant women by strengthening the management of GDM.