妊娠期糖代谢异常并发子痫前期的相关因素分析

目的探讨妊娠期糖代谢异常孕妇并发子痫前期的相关因素.方法回顾性分析2003年1月至2012年12月分娩的18624例孕妇中发生子痫前期孕妇临床资料.结果18624例孕妇中发生子痫前期1397例,妊娠期糖代谢异常465例.465例妊娠期糖代谢异常孕妇中58例并发子痫前期,列为A组,其余407例无并发子痫前期发生,列为B组.A组孕妇糖代谢异常诊断时孕周较B组早,分娩前体重指数（BMI）高于B组,差异均有统计学意义（P〈0.05）.糖代谢异常孕妇子痫前期发生率12.5%（58/465）,所有孕妇中子痫前期发病率7.5%（1397/18624）,差异有统计学意义（P〈0.01）.三种糖代谢异常类型GIGT、GDM、DM的子痫前期发生率分别为7.2%、12.2%、33.4%,差异有统计学意义（P〈0.01）.A组空腹血糖、2h血糖、3h血糖及HbA1c均高于B组,差异有统计学意义（P〈0.05）.血糖未得到控制或疗效欠佳者子痫前期发病率17.8%（35/197）,血糖得到控制或疗效满意者子痫前期发病率8.6%（23/268）,差异有统计学意义（P〈0.01）.多因素回归分析显示HbA1c和高血压是引起子痫前期发病的独立危险因素.结论糖代谢异常及其程度与子痫前期发病率呈正相关关系,孕期内对血糖的控制能减少妊娠糖代谢异常孕妇子痫前期的发病率.

Objective To study associated factors in pregnant women with abnormal glucose metabolism and preeclampsia. Methods 465 patients with abnormal glucose metabolism from January 2003 to December 2012 were analyzed retrospectively,58 cases with abnormal glucose metabolism and pre-eclampsia as group A,and the rest as B group. Results Diagnosis gestational age of glucose metabolism abnormality was earlier in group A than group B,the body mass index（BMI）before childbirth was higher in group A than group B,there was significant（P〈0.05）.Total incidence of preeclampsia in women with abnormal glucose metabolism and pre-eclampsia was 12.5%（58/465）,incidence rate of preeclampsia in pregnant women was 7.5%（1397/18624）, there was significant（P〈0.01）.Preeclampsia incidence was 7.2%,12.2%and 33.4%in women with GIGT,GDM,DM,there was significant（P〈0.01）.Fasting blood glucose,2h blood glucose,3h blood glucose and HbA1c were higher in group A than group B,there were significant（P〈0.05）. preeclampsia was 17.8%（35/197）in women whose blood glucose were under control or poor efficacy,and was 8.6%（23/268）in women whose blood glucose were controld satisfactoryly,there were significant （P〈0.01）.Multivariate regression analysis found HbA1c and hypertension were independent risk factors caused preeclampsia. Conclusion The degree of abnormal glucose metabolism and preeclampsia incidence is positively correlated,blood glucose control can reduce the incidence of preeclampsia in pregnant women with abnormal glucose metabolism.