妊娠期糖尿病并发症相关因素的分析

Clinical observation of the risk factors of pregnancy complications in gestational diabetes mellitus

目的探讨GDM患者并发症的相关危险因素。方法 134例GDM患者分为无并发症组及并发症组。测定两组C-RP、FPG、FIns及血脂水平;记录母婴并发症发生情况;分析各危险因素与并发症的相关性。结果 GDM+并发症组C-RP、FPG、孕前BMI和孕晚期BMI均高于单纯GDM组[(5.46±4.20)vs(2.60±2.76)mg/L、(5.68±1.36)vs(5.25±0.77)mmol/L、(24.79±3.92)vs(23.03±2.51)kg/m2、(29.05±3.79)vs(27.25±2.58)kg/m2](P<0.05)。相关分析显示,C-RP与FPG呈正相关(P<0.05)。Logistic回归分析显示,孕晚期BMI、C-RP、TG和HDL-C是母体发生并发症的危险因素;C-RP是新生儿发生并发症的危险因素。结论 C-RP、血脂、孕晚期BMI与GDM母婴并发症发生密切相关;积极控制血糖、合理控制体重增加和血脂有助于减轻炎症反应,改善妊娠不良结局。

Objective To explore the risk factors of pregnancy complications in patients with gestationaldiabetesmellitus（GDM）.Methods 134patientswithGDMweredividedintocontrolgroup without complication （n= 38） and complication group（n= 96）.Serum fasting levels of glucose （FPG） , insulin ,lipid and C‐reactive protein （C‐RP） were measured. Both maternal and fetal complications of pregnancy were recorded. Results The levels of C‐RP ,FPG ,progestation BMI and lategestation BMI were significantly increased in complication group than in control group [（5.46 ± 4.20） vs （2.60 ± 2.76） mg/L ,（5.68 ± 1.36） vs （5.25 ± 0.77）mmol/L ,（24.79 ± 3.92） vs （23.03 ± 2.51）kg/m^2 ,（29.05 ± 3.79） vs （27.25 ± 2.58）kg/m^2 respectively ,P〈 0.05].The C‐RP level is significantly associated with FPG.Logistic analysis showed that maternal complications were significantly related to lategestation BMI ,C‐RP , TC and HDL‐C.Infant complications were significantly related to C‐RP. Conclusion C‐RP ,lipid and late gestation BMI play important roles in the development of maternal‐neonatal complications during pregnancy. Keeping rational levels of glucose ,lipid and weight gain are helpful for improving pregnancy outcomes.