不同孕周妊娠期糖尿病合并早发型重度子痫前期的临床特征分析及对母婴结局的临床影响

Analysis of clinical characteristics of gestational diabetes mellitus complicated with early onset severe pre-eclampsia at different gestational ages and its clinical impact on maternal and child outcomes

目的探讨不同孕周妊娠期糖尿病合并早发型重度子痫前期的临床特征及对母婴结局的临床影响。方法 56例妊娠期糖尿病合并早发型重度子痫前期产妇,根据孕周不同将其分为a组(32例,孕周<31周)与b组(24例,孕周31~33周)。两组产妇均给予相应治疗。观察比较两组产妇期待治疗时间、并发症、围生儿结局。结果 b组产妇期待治疗时间(7.81±2.54)d短于a组的(10.34±3.24)d、严重并发症总发生率29.17%低于a组的62.50%,差异均具有统计学意义(P<0.05)。b组新生儿窒息、胎儿生长受限、新生儿脑室内出血发生率4.17%、4.17%、8.33%均低于a组的25.00%、28.13%、31.25%,Apgar评分(8.32±1.62)分高于a组的(6.13±1.22)分,差异均具有统计学意义(P<0.05)。结论妊娠期糖尿病合并早发型重度子痫前期孕周越小对母婴危害越大,且母婴结局越差。

Objective To investigate the clinical characteristics of gestational diabetes mellitus complicated with early onset severe pre-eclampsia at different gestational ages and its clinical impact on maternal and child outcomes. Methods A total of 56 pregnant women with gestational diabetes mellitus complicated with early onset severe pre-eclampsia were divided by different gestational ages into group a （32 cases, gestational ages〈31 weeks） and group b （34 cases, gestational ages of 31-33 weeks）. Both groups received appropriate treatment. Observation and comparison were made on expected treatment time, complications, perinatal outcome between two groups. Results Group b had shorter expected treatment time as （7.81 ± 2.54） d than （10.34± 3.24） d in group a, and lower overall incidence of severe complications as 29.17% than 62.50% in group a. Their difference was statistically significant （P〈0.05）. Group b had lower incidence of neonatal asphyxia, fetal growth restriction and neonatal intraventricular hemorrhage as 4.17%, 4.17% and 8.33% than 25.00%, 28.13% and 31.25% in gr6up a, and higher Apgar score as （8.32 ± 1.62） points than （6.13 ± 1.22） points in group a. Their difference was statistically significant （P〈0.05）. Conclusion For gestational diabetes mellitns complicated with early onset severe preeclampsia, the smaller gestational age, the greater the harm to mother and baby, and the worse the outcome of mother and baby.