妊娠期糖尿病与妊娠结局的临床分析

Clinical Analysis of Gestational Diabetes and Pregnancy Outcome

目的：探讨妊娠期糖尿病（GDM）对孕妇妊娠结局和胎儿健康的影响。方法：回顾性分析2009 年8 月～2012 年12 月在我院分娩的184 例GDM 患者及200 例健康孕妇的临床资料，并对两组孕妇的妊娠结局进行比较。结果：GDM 组妊高症35 例（19.0%）、羊水过多17 例（9.2%）、早产21 例（11.4%）、产后出血14 例（7.6%）、产褥感染12 例（6.5%），发生率均显著高于对照组（P〈0.05）；GDM组中发生巨大儿48 例（26.1%）、新生儿低血糖31 例（16.8%），与对照组比较均显著增高（P＜0.05），而胎儿宫内窘迫的发生率（3.3%）也较对照组升高，但差异无统计学意义（P＞0.05）；GDM组剖宫产141 例（76.6%），阴道产43 例（23.4%），剖宫产比例较对照组显著升高（P〈0.05）。结论：GDM对孕妇的妊娠结局有不利影响，孕妇应加强孕期保健，规范治疗妊娠期糖尿病，减少各种并发症的发生。

Objective： To study the influence of gestational diabetes mellitus （GDM） on the outcome of gravida and fetal health. Methods： The clinical data of 184 cases of GDM patients and 200 cases of healthy gravida were retrospectively analyzed, the pregnancy outcome of two groups was compared. Results： In GDM group, 35 cases of pregnant period hypertensive disorders （19%）, 17 cases of polyhydramnios（9.2%）, 21 cases of premature delivery（11.4%）, 14 cases of postpartum hemorrhage（7.6%）, 12 cases of puerperal infec- tion（6.5%） were found, which were all significantly higher than those in the control group（P〈0.05）; 48 cases of rnacrosomia （26.1%）, 31 cases of neonatal hypoglycemia （16.8%） were all significantly higher than those in the control group （P〈0.05）, and fetal distress rate （3.3%） was higher than that of the control group, but there was no significant difference between two groups （P〉0.05）. In GDM group, 141 cases of cesarean section （76.6%）, 43 cases of vaginal delivery （23.4%）, and the rate of cesarean section were all significantly in- creased compared with the control group （P〈0.05）. Conclusion： GDM had adverse effects on the outcome of pregnancy, gravida should strengthen the health care during pregnancy, and accept the standard treatment of gestational diabetes mellitus, decrease the complications.