不同诊断标准对妊娠期糖尿病妊娠结局的影响

Effect of Different Diagnostic Criteria for Gestational Diabetes on Pregnancy Outcome

目的研究美国国家糖尿病数据组(NDDG)诊断标准与国际糖尿病与妊娠研究组(IADPSG)诊断标准对妊娠期糖尿病(gestational diabetes mellitus,GDM)妊娠结局的影响。方法将2014年7月至2016年6月于我院妇产科行产前检查、分娩的妊娠女性1868例纳入本研究,其中2014年7月至2015年6月以NDDG诊断标准诊断出的GDM孕妇纳入NDDG组,将2015年7月至2016年6月以IADPSG诊断标准诊断出的GDM孕妇纳入IADPSG组。所有诊断为GDM孕妇均给予血糖干预、饮食控制及加强锻炼等方法进行血糖控制。观察不同诊断标准下GDM检出率,NDDG组、IADPSG组不良孕妇妊娠结局及新生儿不良分娩结局等指标。结果 NDDG标准下GDM检出率(3. 29%)低于IADPSG标准下GDM检出率(5. 48%),差异有统计学意义(P<0. 05)。NDDG组与IADPSG组GDM孕妇一般资料差异无统计学意义(P>0. 05)。NDDG组GDM孕妇不良妊娠发生率(79. 31%)、新生儿不良分娩发生率(41. 38%)均高于IADPSG组GDM孕妇不良妊娠发生率(50. 00%)、新生儿不良分娩发生率(18. 52%),差异有统计学意义(P<0. 05)。结论 IADPSG诊断标准可有效提高GDM的检出率,降低不良妊娠发生率。

Objective To study the effect of diagnostic criteria of National Diabetes Data Group （NDDG） and The International Association of Diabetes and Pregnancy Study Groups （IADPSG） for gestational diabetes mellitus （ GDM ） on the outcome of pregnancy. Methods 1868 pregnant women from department of obstetrics and gynecology in our hospital for prenatal care and childbir）h from July 2014 to June 2016 were included in the study. Pregnant women with GDM diagnosed by NDDG standard from July 2014 to June 2015 were included in NDDG group, while pregnant women with GDM diagnosed by the standard of IADPSG from July 2015 to June 2016 were included in IADPSG group. All pregnant women diagnosed with GDM were given GDM intervention, diet control and toned up with more exercise to control blood glucose. The detection rate of GDM with different diagnostic criteria, adverse pregnancy outcomes, neonatal adverse birth outcomes both in NDDG group and IADPSG group were observed. Results The detection rate of GDM with the standard of NDDG （3.29%） was lower than that with the standard of IADPSG （5.48%）, with statistically significant difference （P 〈 0. 05 ）. There was no significant difference in the aspect of general information of GDM pregnant women be）ween NDDG group and IADPSG group （P〉0. 05 ）. The incidence of adverse pregnancy in group NDDG （79. 31% ） was higher than that in group IADPSG （50%）. The incidence of adverse newborns in group NDDG （41.38%） was higher than that in group IADPSG （ 18.52% ）. The difference was significant （P 〈0. 05 ）. Conclusion The diagnostic criteria of IADPSG can effectively improve the detection rate of GDM and reduce the incidence of adverse pregnancy.