妊娠期糖尿病并发感染的发生情况及影响因素分析

Incidence of gestational diabetes mellitus combined with infection and influencing factors

目的 探讨妊娠期糖尿病（GDM）患者合并感染的发生情况及相关影响因素,研究有效的预防措施.方法 选取于2010年1月～2013年12月在我院进行检查分娩的84例GDM患者为GDM组,同时选取在我院产科进行正常产检分娩的健康孕妇84例作为对照组,对比两组妊娠期间的感染发生情况,分析GDM组合并感染的影响因素.结果 GDM组妊娠期间发生感染41例,感染率为48.81％;对照组发生感染9例,感染率为10.71％,两组感染率差异具有统计学意义（P＜0.05）.GDM组中,孕中期感染率（43.90％）显著高于其余孕期（21.95％、9.76％、24.39％）,年龄＞30岁的孕妇感染率（73.33％）明显高于≤30岁的孕妇（35.19％）,发生胎膜早破的孕妇感染率（83.33％）明显高于没有发生胎膜早破的孕妇（43.06％）,血糖≥10.0 mmoL/L孕妇的感染率（71.43％）高于血糖8.6 ～9.9 mmol/L（40.00％）及血糖7.0 ～8.5 mmol/L（34.62％）的孕妇,餐前尿糖阳性的孕妇感染率（60.00％）高于阴性的孕妇（10.53％）,且空腹血糖及餐前尿糖水平越高,感染的发生率越高.结论 GDM患者较健康孕妇容易发生感染,孕中期为感染多发时期,应引起重视;血糖水平、胎膜早破、年龄可能是导致感染发生的主要因素,临床应重点关注.合理的日常饮食控制、孕期良好的卫生及定期的检查能有效预防GDM合并感染的发生.

Objective To discuss the incidence of gestational diabetes mellitus （GDM） combined with infection and the correlated influencing factors.Methods 84 cases with GDM were selected out from Jan.,2010 to Dec.,2013 to be GDM group,while 84 normal pregnant cases were selected in the same period to be control group;the incidences of infection in the 2 groups were compared and the influencing factors for combined infection in GDM group was analyzed.Results Gestational infection occurred in 41 cases in GDM group and the infected rate was 48.81％,while infection occurred in 9 cases in control group and the infected rate was 10.71％,the difference of infected rate between the 2 groups was of statistical significance （P ＜ 0.05） ; In GDM group,the infected rate of the pregnant women in second trimester（43.90％）was much higher than those of the pregnant women in other times of pregnancy （21.95％,9.76％ and 24.39％）;the infected rate of the pregnant women aged over 30（73.33％）was much higher than that of the pregnant women at the age 30 or under 30 （35.19％） ;the infected rate in the pregnant women with premature rupture of membranes （PROM） （83.33％）was higher than that in the pregnant women without PROM （43.06％） ;the infected rate of the pregnant women with blood sugar of over 10.0 mmol/L（71.43％） was higher than that of the pregnant women with blood sugar of 8.6-9.9 mmol/L （40.00％）and the women with blood sugar of 7.0-8.5 mmol/L（34.62％）;the infected rate of the pregnant women with positive preprandial urine sugar（60.00％）was higher than that of the pregnant women with negative preprandial urine sugar（10.53％） ;the higher the levels of fasting blood sugar and preprandial urine sugar were,the higher the infected rates were.Conclusions Infection is prone to occur in pregnant women with GDM,especially in second trimester; the level of blood sugar,PROM and age are the main factors for the occurrence of infection;proper control of daily diet,good gestational hygiene and regular examination can effectively prevent the occurrence of GDM combined with infection.