两种标准诊断妊娠期糖尿病妊娠结局的对比观察

The comparison of pregnant outcome by using two kinds of diagnostic criteria for gestational diabetes mellitus

目的对比教科书标准和国际妊娠与糖尿病研究组织(IADPSG)标准诊断妊娠期糖尿病的母婴结局。方法 2011年至2012年在煤炭总医院诊断并分娩的妊娠期糖尿病患者246例,按不同诊断标准分为两组,教科书组(73例)和IADPSG组(173例),并给予相应的临床干预,对比两组患者的母婴结局。结果教科书标准诊断GDM的诊断率为9.61%,IADPSG标准为14.62%,差异有统计学意义(P<0.05)。比较两组患者胎膜早破的发生率:教科书组为38.36%,IADPSG组为23.12%,差异有统计学意义(P<0.05)。而比较两组患者胰岛素使用率、孕期体重增长、剖宫产率及巨大儿、妊娠期高血压、羊水过多、产后出血、胎儿宫内窘迫、新生儿高胆红素血症、新生儿低血糖发生率差异均无统计学意义(P>0.05)。结论 IADPSG标准诊断妊娠期糖尿病,可以提高诊断率,改善不良母婴结局。

Objective To compare the pregnancy outcomes by using traditional（seventh edition of ＂obstetrics and gynecology＂）and IADPSG diagnostic criteria for GDM.Methods 246 pregnant women who diagnosed as GDM and delivered in China Meitan Genenral Hospital from 2011 to 2012 were recruited in this study.According to the two different diagnostic criteria,they were assigned into textbook group and IADPSG group.The outcomes of the maternal and neonate of the two groups were compared.Results The diagnostic rate of GDM was 9.61% in the text book group and 14.62% in IADPSG group（P＆lt;0.05）.The incidence of premature rupture of membrane was 38.36% in textbook group and was 23.12% in IADPSG group,the difference was significant（P＆lt;0.05）.While there were no significant differences of insulin use rate,weight gain during pregnancy and the rate of cesarean section between the two groups.There were no significant difference of the incidence of fetal macrosomia,hypertensive disorders in pregnancy,polyhydramnios,postpartum hemorrhage,fetal distress in uterus,neonatal jaundice and neonatal hypoglycemia between the two groups,either.（P＆gt;0.05）.Conclusion IADPSG diagnostic criteria may improve diagnostic rate and reduce adverse pregnancy outcomes.