妊娠期糖尿病新诊断标准对妊娠结局的意义

The significance of the new diagnostic code of GDM on the pregnancy outcome

目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)新诊断标准实施前后1年对妊娠期糖尿病的诊断率、孕妇及围生儿临床结局的意义。方法收集我院执行新诊断标准前后一年的同年龄段、孕前体重指数(BMI)在正常范围即18.5≤BMI<23,孕前无内科合并症及不良妊娠史的产妇分为A组(2234例)和B组(2012例),分析GDM诊断率,孕产妇和围生儿并发症率方面有无差异。结果经新诊断标准纳入并治疗后,B组妊娠期高血压、羊水过多、巨大儿、新生儿低血糖发生率低于A组,P<0.01;B组切口感染、新生儿呼吸窘迫综合症也低于A组P<0.05;胎膜早破、产后出血及早产、死胎、胎儿生长受限差异无统计学意义,P>0.05。结论执行GDM新诊断标准指导临床血糖管理可以降低母儿并发症,且不会增加胎儿生长受限。

Objective To discuss the clinical result of maternal and fetus between the new diagnostic code of gestational diabetes mellitus （GDM） excution anterior-posterior one year, and change of diagnosis ratio. Methods According to the same age stage,range of BMI（ 18.5 ≤ BMI 〈 23）,without of complication of internal medicine and bad history of pregnancy before gesta- tion,we collected pregnant wowen beween January. 2009 and January. 2011 and classified into A group （2234cases） and B group （2012cases） by the two diagnostic code of GDM. The difference of GDM diagnosis ratio,complication of aternal and fetus were an- alyzed. Result Through diagnosis and treatment by new diagnostic code, the morbidity of PIH, polyhydramnios, fetal macroso- mia,hypoglycemia of newborn in B group were lower than those in A group （P 〈 0.01 ）, the morbidity of postoperative infection, ARDS of newborn in B group were lower than those in A group too （ P 〈 0. 05 ）, but the morbidity of PROM, postpartum hemor- rhage,premature labor,dead fetus,FGR had no statistically significant（P 〉 0.05）. Conclusion To carry out the new diagnostic code of GDM and to guide managing blood glucose, that could decrease the complication of maternal and fetus, but could not in- crease the morbidity of FGR.