妊娠期糖代谢异常对母儿的影响

The Effect of Gestational Abnormal Metabolism of Glucose on Outcome of Pregnancy

【目的】了解妊娠期糖代谢异常对孕妇、胎儿和新生儿的影响。【方法】对 378名孕妇在孕 2 4～ 34周作 5 0g葡萄糖激发试验 ,阳性者再作 75 g葡萄糖耐量试验。根据血糖结果将 378名孕妇分糖代谢正常组 (包括 5 0 g葡萄糖激发试验和75g葡萄糖耐量试验正常者 ) ,妊娠期糖尿病组和妊娠期糖耐量减低组 ,对这 3组孕妇及围生儿妊娠结局进行比较。【结果】妊娠期糖尿病和妊娠期糖耐量减低的患病率分别为 3 1%和 6 3%。妊娠期糖尿病组早产、酮症酸中毒及新生儿高胆红素血症的发生率明显高于糖代谢正常组 ,但与妊娠期糖耐量减低组间无差别 ;妊娠期糖尿病和妊娠期糖耐量减低孕妇的妊娠高血压综合征、羊水过多、巨大儿、新生儿低血糖发生率和剖宫产率均高于糖代谢正常组 ,而妊娠期糖尿病和妊娠期糖耐量减低两组间无差别。【结论】妊娠期糖代谢异常能增加孕妇和围生儿的患病率 ,应重视孕期糖代谢异常的筛查、诊断和治疗。

To understand the adverse effect of gestational abnormal metabolism of glucose on outcome of pregnancy. 378 pregnant women at gestational age of 24～34 weeks were screened with the 50 g glucose challenge test (GCT), positive reaction subjects further took oral 75 g glucose tolerance test (OGTT). They were divided into the following groups: group of 342 pregnant women with normal response to 50 g GCT and 75 g OGTT, group of 12 pregnant women with gestational diabetes mellitus (GDM) and group of 24 pregnant women with gestational impaired glucose tolerance (GIGT). The pregnant outcome were compared in these three groups. The frequency of GDM and GIGT was 3 1% and 6 3% respectively. The incidence of premature delivery, diabetic ketoacidosis and hyperbilrubinemia of neonate in the GDM group were higher than that in the group with normal gestational glucose metabolism (P<0 05), the incidences of pregnancy induced hypertension, polyhydramnios, fetal macrosomia, neonatal hypoglycemia, and rate of cesarean section in the groups of GDM and GIGT were higher than that in the control group (P<0 05). There were no significant differences in the incidences of the above mentioned complications between the groups of GDM and GIGT. [Conclusion] Abnormal metabolism of glucose in pregnancy can increase the morbidity of mothers and neonates. It is very important to make early detection, early diagnosis and treatment for abnormality of glucose metabolism during pregnancy.