新诊断标准妊娠期糖尿病规范化管理的妊娠结局分析

Analysis on the pregnancy outcome of gestational diabetes mellitus based on standardized management of a new diagnostic criterion

目的:探讨规范化管理对按卫生部2011年7月颁布的妊娠期糖尿病新诊断标准诊断的妊娠期糖尿病(GDM)妊娠结局的影响。方法:收集按新标准确诊GDM并接受规范化管理的患者184例作为研究组,同期未接受规范化管理的GDM患者116例作为对照组,比较分析两组妊娠结局。结果:研究组的子痫前期、羊水过多、胎儿窘迫、巨大胎儿、剖宫产率较对照组升高,差异有统计学意义(P<0.05);产后出血、产褥感染、酮症酸中毒、早产、围产儿死亡、胎儿畸形及新生儿窒息与对照组比较,差异无统计学意义(P>0.05)。结论:对GDM患者实施规范化管理,可有效减少母婴并发症,改善妊娠结局。GDM新诊断标准下GDM发病率增高,妇幼保健机构应做好GDM管理。

Objective To explore the effect of standardized management on pregnancy outcome of gestational diabetes mellitus （GDM） based on a new diagnostic criterion of GDM issued by Ministry of Health in July 2011. Method A total of 184 GDM patients based on a new diagnostic criterion and receiving standardized management were collected as study group, 116 GDM patients not receiving standardized management during the same period were selected as control group ; the pregnancy outcomes in the two groups were compared and analyzed. Results The incidence rates of preeclampsia, polyhydrananios, fetal distress, macrosomia and cesarean section rate in study group were significantly higher than those in control group（ P 〈 0. 05 ） ; there was no statistically significant difference in the incidence rates of postpartum hemorrhage, puerperal infection, ketoaeidosis, premature delivery, perinatal death, fetal malformation, and neonatal asphyxia between study group and control group （P 〉 0.05 ）. Conclusion Conducting standardized management among GDM patients can effectively reduce maternal and infantile complications and improve pregnancy outcome;the incidence rate of GDM increases under the new diagnostic criterion of GDM,GDM management should be enhanced in maternal and child health care institutions.