血糖控制对妊娠期糖尿病孕妇妊娠结局的影响

Impact of glycemic control on pregnancy outcome in pregnant women with gestational diabetes mellitus

目的分析血糖控制水平对妊娠期糖尿病(GDM)孕妇妊娠结局的影响。方法回顾性分析120例妊娠期糖尿病孕妇的临床资料。其中,治疗后,血糖控制不良者48例(A组),空腹血糖(FBG)>5.6mmol/L或餐后-2-h血糖(2-hPG)>6.7mmol/L),血糖控制良好者72例(B组,FBG≤5.6mmol/L,2-hPG≤6.7mmol/L);另选无GDM产妇54例作为对照(C组)。比较三组的妊娠结局。结果 A组孕妇的妊娠期高血压疾病和剖宫产率高于B组(12.5%vs.1.39%和16.67%vs.4.17%)(P<0.05),而且早产儿、巨大儿、胎儿窘迫和新生儿窒息的比例也高于B组(14.58%vs.2.78%、18.75%vs.4.17%、16.67%vs.2.78%和22.92%vs.4.17%)(P<0.05)。B组的上述指标均与C组相仿(P>0.05)。结论 GDM孕妇血糖控制不良会导致妊娠期高血压疾病、剖宫产、胎儿发生早产儿、巨大儿、胎儿窘迫和新生儿窒息等并发症发生率增高,控制血糖对GDM孕妇具有重要意义。

Objective To analyze the impact of gl＇ycemic control on the pregnancy outcome of pregnant women with gestational diabetes mellitus （GDM）. Methods Data of 120 pregnant women with GDM were retrospectively analyzed. The GDM patients underwent conventional DM-reducing therapy. The blood glucose（BG） was not well controlled in 48 cases（group A） with FBG〉5.6 mmol/L or 2-hPG〉6.7 mmol/L and well controlled in 72 cases（group B） with FBG〈5.6 mmol/L or 2-hPG 〈6. 7 mmol/L. Another 54 normal glycemic pregnant women were taken as the controls（group C）. The pregnancy outcomes were compared among three groups. Results The incidence rates of pregnancy-induced hypertension and Cesarean section were higher in group A than those in group B （12. 5% vs. 1.39% and 16.67% vs. 4. 17%）（P〈0. 05）. So did the percentages of premature, fetal macrosomia,fetal distress and asphyxia neonatorum（14. 58% vs. 2.78%, 18. 75% vs. 4. 17%, 16.67% vs. 2.78% and 22.92% vs. 4. 17%）（P〈0. 05）. The indicators mentioned above of group B and group C were similar（P〉0. 05）. Conclusion The GDM patients without well contrlled BG are easy to have pregnancy-induced hypertension, higher incidence rates of Cesarean section, premature, fetal macrosomia, fetal distress and asphyxia neonatorum. It is＇important to control BG in GDM women.