妊娠期糖尿病治疗时机对母婴预后的影响

Influence of Gestational Diabetes Mellitus in Treatment Time on Prognosis of Maternal and Neonatal

目的观察妊娠期糖尿病治疗时机对母婴预后的影响。方法 2011年1月—2014年10月,在该院就诊并分娩的妊娠期糖尿病患者130例,根据不同的治疗时机分为三组,孕早期组、孕中期组及孕晚期组。孕早期组在孕18周以内、孕中期组在孕18-32周、孕晚期组在孕32周以后确诊并且进行降糖治疗。对所有患者利用饮食调理、运动指导、个体给药等综合进行治疗,控制患者血糖水平,并且治疗过程中,对各产妇进行孕期监护。检测3组分娩前后血糖,观察孕妇围产并发症及新生儿不良结局发生率。结果 3组孕妇在分娩前及分娩后检测血糖,孕晚期组患者血糖水平最高,孕中期组次之,孕早期组患者最低,P〈0.05;3组孕妇围产并发症发生率比较,孕晚期患者最高（52.6%）,孕中期次之（42.9%）,孕早期患者最低（20.9%）,P〈0.05;3组新生儿不良结局发生率比较,孕晚期组最高（44.7%）,孕中期次之（30.6%）,孕早期组最低（14.0%）,P〈0.05。结论妊娠期糖尿病的治疗时机影响妊娠结局,治疗时机越早,干预效果越好,早期干预治疗可有效降低妊娠期糖尿病孕妇及新生儿并发症的发生率,保障母婴健康。

Objective To observe the influence of diabetes treatment time on prognosis of the period of pregnancy on maternal and neonatal. Methods From January 2011 to October2014, 130 cases of gestational diabetes patients in the hospital childbirthwere divided into 3 groups：early pregnancy group, the second trimester and late pregnancy group group , according to the different treatment time . Early pregnancy group at 18 weeks of pregnancy, second trimester pregnancy within the group in 18 weeks -32 weeks, late pregnancy group after 32 week pregnancy diagnosed and hypoglycemic treatment. For all patients using diet, exercise guidance, individual administration comprehensive treatment, control of blood glucose level in patients, and the treatment process, carried on each maternal care during pregnancy. Detection of the 3 groups before and after the delivery of blood glucose, observation of pregnant women in perinatal complications and the incidence of adverse neonatal outcomes. Results The 3 groups of pregnant women, the detection of blood glucose before delivery and after birth, late pregnancy group blood sugar level is the highest, the second trimester group, early pregnancy patients with the lowest group, P〈0.05; 3 groups of pregnant women and perinatal complication rate comparison, late pregnancy in patients with the highest （52.6%）, the second trimester of pregnancy （42.9%）, early in patients with the lowest （20.9%）, P 〈 0.05; adverse outcome in 3 groups rate comparison, late pregnancy group was the highest （44.7%）, the second trimester of pregnancy （30.6%）, the early group was the lowest （14%）, P〈0.05. Conclusion The effect of treatment time of pregnancy outcome of gestational diabetes mellitus, timing of treatment the sooner, the better the effect of intervention, early intervention can effectively reduce the period of diabetic pregnant women and neonatal complications incidence of pregnancy, maternal and child health protection.