不同妊娠期糖尿病诊断标准对妊娠结局的影响探讨

Influences of two different diagnostic criteria of gestational diabetes mellitus on pregnant outcome

目的探讨不同妊娠期糖尿病(GDM)诊断标准及对妊娠结局的影响。方法选择我院进行糖筛查和分娩的孕产妇519例,运用2008年第7版《妇产科学》诊断GDM患者31例,为教科书组;使用国际妊娠合并糖尿病研究组(IADPSG)诊断GDM患者42例,为IADPSG组。比较其GDM检出率、分娩方法、妊娠结局及并发症。结果教科书组检出率、阴道分娩率、羊水过多发生率及胎膜早剥发生率与LADPSG组比较,差异均有统计学意义(P<0.05);2组孕妇的产钳助产、有指征剖宫产率、妊娠高血压综合征、胎儿窘迫发生率及产后出血率比较,差异无统计学意义(P>0.05)。结论采用IADPSG诊断标准会使更多孕妇纳入诊断,利于早期干预,减少母婴并发症的发生。

ObjectiveTo investigate two kinds of diagnostic criteria for gestational diabetes mellitus and pregnancy outcome.Methods519 pregnant women who diagnosed and given glucose screening,there were 260 pregnant women,among them,31 pregnant women was diagnosed according to the criteria in 7th edition of ＂Obstetrics and Gynecology＂（textbook group）,there were 259 pregnant women from 2011 July to 2011 December, among them,42 pregnant women was diagnosed according to the criteria International Diabetes and Pregnancy Study Group（International Association of Diabetes and Pregnancy Study Groups,IADPSG group）.We compared the GDM detection rates,mode of delivery,pregnancy outcomes and complication between the two groups.ResultsThe GDM detection rates、vaginal delivery rates of IADPSG group were significantly higher than textbook group（P〈0.05）, There were no significant differences of forceps delivery、rates of necessary caesarean birth、the incidence of pregnancy induced hypertension syndrome、the incidence of intrauterine asphyxia and rates of postpartum hemorrhage of between two groups（P〉0.05）,the incidences of hydramnios and premature rupture of membranes peeling of textbook group were significantly higher than IADPSG group（P〈0.05）.ConclutionUsing IADPSG diagnostic criteria would be more into the diagnosis of pregnant women,it was advantageous to interven early,and reduce maternal and child complications.