妊娠期不同糖耐量状况对妊娠结局的影响

Effect of different glucose tolerance status during pregnancy on pregnancy outcome

目的:探讨妊娠期不同糖耐量状况对妊娠结局的影响。方法:选取1 701例有完整产检记录并在院分娩的正常单胎孕妇,按妊娠期血糖状况分为妊娠期糖耐量异常组(GIGT组)、妊娠期糖尿病组(GDM组)、血糖正常组(对照组),对孕妇资料进行回顾性分析。结果:GIGT组及GDM组孕妇年龄均明显高于对照组(P<0.01),GDM组孕妇孕前体质量、超重及肥胖率均高于对照组(P<0.01和P<0.05),GIGT组孕妇孕前体质量低于GDM组(P<0.01),而3组孕妇产前体质量及体质量指数差异均无统计学意义(P>0.05)。GIGT组和GDM组孕妇胎膜早破与羊水过多发生率均高于对照组(P<0.05),GDM组孕妇巨大儿和剖宫产率均高于对照组(P<0.05),而GIGT组孕妇剖宫产率低于GDM组(P<0.05),3组孕妇产后出血率差异有统计学意义(P<0.01),而3组孕妇妊娠期高血压疾病、早产、甲状腺功能减退的发生率差异均无统计学意义(P>0.05)。结论:GIGT与GDM同样危害母儿健康,应予以重视;适龄生育,控制孕前体质量,可减少GIGT及GDM的发生。

Objective： To investigate the effects of different glucose tolerance status during pregnancy on pregnancy outcome. Methods： One thousand seven hundred and one singleton pregnant women were divided into the gestational impaired glucose tolerance group（GIGT group）, gestational diabetes meUitus group （GDM group） and euglycemia group （control group） according to the blood sugar status in pregnancy. The data of patients were retrospectively analyzed. Results： The maternal age in GIGT group and GDM group were significantly higher than that in control group（P 〈0.01 ）. The pre-pregnancy weight,over weight and obesity rates in GDM group were higher than those in control group （ P 〈 0.01 and P 〈 0.05 ）. The pre-pregnancy weight in GIGT group was lower than that in GDM group（ P 〈 0.01 ）, but the differences of the prenatal weight and BMI between three groups were not statistically significant（ P 〉 0.05 ）. The incidence rates of the premature rupture of membrane and polyhydramnios in GIGT and GDM groups were higher than those in control group（ P 〈 0.05 ） ,the incidence rates of macrosomia and cesarean in GDM group were higher than those in control group（ P 〈 0.05）, and the incidence rate of cesarean in GIGT group was lower than that in GDM group （ P 〈 0.05 ）. The differences of the incidence rates of postpartum hemorrhage between three groups were statistically significant（ P 〈 0.01 ）. The differences of the incidence rates of hypertensive disorders in pregnancy, premature birth and hypothyroidism between three groups were not statistically significant （ P 〉 0.05 ）. Conclusions： Both GIGT and GDM can harm the health of mothers and children, which should be emphasized. The proper pregnancy and controlling pre-pregnancy weight can reduce the incidences of GDM and GIGT.