妊娠期糖尿病的早期干预对母婴预后的影响

Evaluate the correlation of early intervening treatment and adverse pregnancy outcomes in gestational diabetes mellitus

目的探讨妊娠期糖尿病(GDM)的早期干预对母婴预后的影响。方法选择143例GDM孕妇,将其中经早期干预、血糖控制满意的75例GDM孕妇作为GDM治疗组;余下68例血糖控制不满意或未行干预的GDM孕妇作为阳性对照组,另选择130名正常孕妇作为阴性对照组。比较3组孕妇的妊娠并发症及围生儿并发症发生率。结果 3组孕妇的妊娠期高血压疾病、羊水过多、胎膜早破、胎儿窘迫发生率及剖宫产率比较差异均有统计学意义(P均<0.01)。其中阳性对照组的妊娠期高血压疾病、羊水过多、胎膜早破、胎儿窘迫、早产儿、新生儿低血糖、巨大儿、新生儿窒息发生率和剖宫产率均高于GDM治疗组(P<0.01或0.05);除早产儿发生率外,GDM治疗组各项妊娠及围生儿并发症发生率及剖宫产率与阴性对照组比较差异均无统计学意义(P均>0.05)。结论早期筛查发现GDM,并及早给予有效干预是降低母婴并发症、改善母婴预后的重要措施。

Objective To evaluate the effect of early intervention on gestational diabetes mellitus （GDM） for outcomes of maternal and fetal. Methods 143 cases of pregnant women with GDM were included. 75 cases with satisfactory blood glucose control by early intervention were selected as GDM treatment group. Another 68 pregnant women with glucose poorly controlled undertaking or untreated were selected as positive control group. Then 130 normal pregnant women were selected as negative control group. The maternal and fe-tal complications of pregnant women among three groups were compared. Results There were statistically sig- nificant differences （P 〈 0. 01 ） of the incidences of hypertensive disorders in pregnancy, polyhydramnios, pre- mature rupture of membranes, fetal distress and cesarean section rate in three groups. The incidences of hyper-tensive disorders in pregnancy, polyhydramnios, premature rupture of membranes, fetal distress, preterm chil-dren, neonatal hypoglycemia, macrosomia, neonatal asphyxia and cesarean section in positive control group were higher than those in GDM treatment group （P 〈 0. 01 or 0. 05 ）. Except for the incidence of premature children, the incidences of the pregnancy and perinatal child complication and the rate of cesarean section in GDM treatment group were not significantly different with the negative control group （ P 〉 0. 05 ）. Conclusion Early screening, timely and effective interventions for GDM is the important way to reduce infant and mater-nal complications.