妊娠期糖尿病与子痫前期发病的关系及对分娩结局的影响

Correlation between gestational diabetic mellitus and onset of preeclampsia and its impact on delivery outcome

目的分析妊娠期糖尿病(GDM)与子痫前期(PE)发病的关系及对分娩结局的影响。方法回顾分析1154例孕妇的病例资料,收集孕妇的一般资料、分娩结局资料,将孕妇是否为妊娠期糖尿病分为GDM组和非GDM组,比较两组患者子痫前期发生情况,分析单纯GDM组、单纯PE组、GDM合并PE组的分娩结局,纳入50例正常孕妇进行分娩结局分析,作为对照研究。结果 1154例孕妇中共有GDM孕妇43例,发病率为3.73%;PE孕妇55例,发病率为4.77%。GDM组PE总发病率为11.63%,明显高于非GDM组的4.50%,差异有统计学意义(P<0.05)。单纯PE组、GDM合并PE组的1 min Apgar评分、5 min Apgar评分、出生体质量明显低于单纯GDM组和正常孕妇组,差异有统计学意义(P<0.05);单纯PE组、GDM合并PE组的转入新生儿重症监护病房(NICU)比例明显高于单纯GDM组和正常孕妇组,差异有统计学意义(P<0.05);单纯GDM组巨大儿比例明显高于单纯PE组和正常孕妇组,差异有统计学意义(P<0.05);GDM合并PE组小于胎龄儿比例、早产率明显高于单纯GDM组、单纯PE组、正常孕妇组,差异有统计学意义(P<0.05)。结论妊娠期糖尿病孕妇合并子痫前期风险显著增加,子痫前期可对分娩结局产生不良影响,应加强孕期管理,积极防治,改善母儿预后。

Objective To analyze the correlation between gestational diabetic mellitus （GDM） and onset of preeclampsia （PE） and its impact on delivery outcome. Methods Case data of 1154 pregnant women was retrospectively analyzed, and general data and delivery outcome data was collected. They were divided by whether it was gestational diabetic mellitus or not into GDM group and non GDM group. Comparison were made on preeclampsia occurrence situation and analysis were made on delivery outcomes of simple GDM group, simple PE group, GDM complicated with PE group. Delivery outcome of 50 normal pregnant women was analyzed for control study. Results Among 1154 pregnant women, there were 43 GDM cases, with morbidity as 3.73%, 55 PE cases, with morbidity as 4.77%. GDM group had obviously higher total PE morbidity as 11.63% than 4.50% in non GDM group, and the difference had statistical significance （P〈0.05）. Simple PE group, GDM complicated with PE group had obviously lower 1 min Apgar score, 5 min Apgar score and birth weights than simple GDM group and normal pregnant women group, and the difference had statistical significance （P〈0.05）. Simple PE group and GDM complicated with PE group had obviously higher proportion of transfer to neonatal intensive care unit （NICU） than simple GDM group and normal pregnant women group, and the difference had statistical significance （P〈0.05）. Simple GDM group had obviously higher proportion of maerosomia than simple PE group and normal pregnant women group, and the difference had statistical significance （P〈0.05）. GDM complicated with PE group had higher small-for-date infant proportion and premature birth rate than simple GDN group, simple PE group and normal pregnant women group, and the difference had statistical significance （P〈0.05）. Conclusion Gestational diabetes mellitus pregnant women has significantly increased risk of preeclampsia. Preeclampsia shows adverse influence on birth outcomes. Gestation management should be strengthened and giving active prevention and treatment, so as to improve the prognosis.