妊娠期糖尿病危险因素及血糖干预对妊娠结局的影响

Study on the Risk Factors of Gestational Diabetes Mellitus and Effect of Blood Sugar Intervention on Pregnancy Outcome

目的探讨妊娠期糖尿病(GDM)发病的危险因素及血糖控制对母婴妊娠结局的影响。方法选取2011年1月至2013年4月在湖北省新华医院行产前检查并确诊为妊娠期糖尿病的孕妇140例为研究对象,根据血糖控制情况将孕妇分为控制良好组(83例)和控制不良组(57例),分析影响GDM发病的危险因素,比较血糖控制良好组和不良组母婴妊娠结局及并发症发生情况。结果控制不良组妊娠期高血压、羊水过多、酮症酸中毒、产后出血、剖宫产手术等的发生率显著高于血糖控制组(P<0.05);控制不良组胎儿早产、巨大儿、新生儿窒息、新生儿低血糖、新生儿高胆红素血症等的发生率也显著高于控制组(P<0.05)。超重或肥胖、妊娠年龄、高血红蛋白血症、月经周期紊乱、不良孕产史、糖尿病家族史6个因素是GDM发病的危险因素。结论应重视GDM发病的危险因素,早发现、早诊断、早治疗GDM,重点控制妊娠期血糖水平,以期降低GDM对母婴妊娠结局的影响。

Objective To explore the risk factors of gestational diabetes mellitus（GDM）,and study the effect of blood sugar intervention on pregnancy outcome.Methods A total of 140 pregnant women underwent prenatal examination and diagnosed as GDM patients in Hubei Xinhua Hospital from Jan.2011 to Apr.2013 were chosen as the research objects and divided into good control group（n = 83） and poor control group（n = 57） according to the condition of blood sugar control.The risk factors of GDM were analyzed and pregnancy outcome and complications of the two groups were compared.Results The complication incidence rates of pregnancy-induced hypertension syndrome,hydramnios,ketoacidosis,postpartum hemorrhage,uterineincision delivery of the poor control group were significantly higher than those of good control group（P〈0.05）,incidence rates of premature delivery,large for date infant,neonatal asphyxia,hypoglycemia of newborn and hyperbilirubinemia of the poor control group were also significantly higher than those of good control group（P〈0.05）.Overweight or obesity,gestational age,hyperhemoglobinemia,menstrual cycle disorder,abnormal pregnancy history and family history of diabetes were the risk factors of GDM.Conclusion It is important for the clinicians to pay more attention on the risk factors of GDM,and make early examination,diagnosis and treatment,in order to control the blood sugar level and improve the pregnancy outcome.