新标准GDM血糖控制正常孕妇早产儿妊娠结局临床分析

Clinical analysis on outcome of preterm infants in GDM pregnant women with normal blood glucose control under new diagnostic criteria

目的分析新标准诊断妊娠期糖尿病(GDM)血糖控制正常孕妇早产儿的胎肺成熟度及新生儿的出生结局与正常孕妇早产儿是否有差异。方法选择90例孕周已满34周未足月难免早产或胎膜早破新标准诊断GDM血糖控制正常孕妇,从阴道后穹隆或剖宫产破膜时取羊水做羊水泡沫试验了解胎儿肺的成熟度,分成34周组、35周组、36周组。90名正常孕妇作为对照组,比较各组孕妇的年龄、分娩方式、胎儿肺的成熟度、新生儿体重、新生儿窒息、新生儿呼吸窘迫综合征(NRDS)、新生儿低血糖、新生儿肺炎等指标。结果两组的产后出血的发生率、剖宫产率、胎儿体重、胎盘重量等指标差异无统计学意义(P>0.05);两组胎儿肺的成熟度和NRDS、新生儿窒息、新生儿低血糖及新生儿感染发生率差异亦无统计学意义(P>0.05)。结论新标准诊断GDM血糖控制正常孕妇,34周以后的早产儿胎肺成熟度及新生儿的出生结局与正常孕妇早产儿相同。

Objective To study whether there are differences in fetal pulmonary maturity and neonatal birth outcome between preterm infants in GDM pregnant women with normal blood glucose control under new diagnostic criteria and preterm infants in normal pregnant women .Methods Ninety pregnant women with gestational age over 34 weeks , who had inevitable preterm labor or premature rupture of membranes and GDM corresponding to the new diagnostic criteria of GDM and had normal blood glucose control , were divided into 34 weeks group , 35 weeks group , 36 weeks group .Another 90 normal pregnant women as control group .The amniotic fluid was taken from viginal fornix or during membrane rupture on cesarean section for making foam test of amniotic fluid understanding of fetal pulmonary maturity.The comparison were performed of maternal age , mode of delivery , fetal pulmonary maturity , neonatal birth weight, neonatal asphyxia , neonatal pneumonia , neonatal hypoglycemia , NRDS index between two groups .Results Between GDM group and control group there were no significant difference in the postpartum hemorrhage rate , cesarean section rate, fetal weight, placental weight, fetal pulmonary maturity and NRDS, neonatal asphyxia rate, neonatal hypoglycemia rate and neonatal infection rate .Conclusion The fetal pulmonary maturity and neonatal birth outcome in preterm infants over 34 gestation weeks in GDM pregnant women with normal blood glucose control under new diagnostic criteria and those in preterm infants in normal pregnant women are same .