胎儿脑-胎盘率与妊娠期糖尿病妊娠结局的关系研究

Relationship between fetal cerebro-placental ratio and gestational diabetes mellitus pregnancy outcome

目的探讨胎儿脑-胎盘率(cerebro-placental ratio,CPR)与妊娠期糖尿病(gestational diabetes mellitus,GDM)妊娠结局的关系。方法回顾性分析2013年1月~2013年12月80例GDM孕妇,分析临床资料和GDM组妊娠结局。通过ROC曲线判断胎儿CPR在GDM孕妇不良妊娠结局中的诊断临界值;利用Logistic回归分析得出影响GDM孕妇不良妊娠结局的危险因素。结果 80例GDM孕妇中不良妊娠结局56例(70. 00%),其中最常见为产后出血、新生儿出生5min Apgar评分<7. 0、胎膜早破、新生儿高胆红素血症、羊水过多;当CPR <0. 92时,GDM产妇出现不良妊娠结局概率大(Z=6. 806,P=0. 003)。Logistic回归分析结果,显示妊娠期高血压、剖宫产、R <0. 92是GDM孕妇不良妊娠结局的危险因素(OR=1. 47,P=0. 002; OR=1. 83,P=0. 005; OR=2. 65,P <0. 001)。结论 GDM患者监测胎儿CPR可有效预测不良妊娠结局,对减少GDM孕妇不良妊娠结局的发生具有一定的参考价值。

Objective To investigate the relationship between fetal cerebro-placental ratio（CPR） and pregnancy outcome of gestational diabetes mellitus（GDM）. Methods The clinical data of 80 pregnant women who diagnosed with gestational diabetes mellitus from January2013 to December 2013 in our hospital were analyzed retrospectively. The clinical data and pregnancy outcome of gestational diabetes group were analyzed. The critical value of fetal CPR in the diagnosis of adverse pregnancy outcomes in GDM pregnant women was determined by ROC curve. Logistic regression analysis was used to identify the risk factors of adverse pregnancy outcomes. Results Abnormal pregnancy of 80 GDM pregnant women was 56 cases（70%）.Most common included postpartum hemorrhage,neonatal 5 min score Apgar 7. 0,premature rupture of membranes,amniotic fluid and neonatal hyperbilirubinemia,polyhydramnios. Probability of GDM maternal adverse pregnancy outcome increased when CPR 0. 92（Z = 6. 806,P= 0. 003）. Logistic regression analysis showed that cesarean,CPR 0. 92 and gestational hypertension were risk factors for adverse pregnancy outcomes in GDM pregnant women（OR =1. 47,P = 0. 002; OR = 1. 83,P = 0. 005; OR = 2. 65,P 0. 001）. Conclusion Detectionof fetal CPR in gestational diabetes mellitus can effectively predict adverse pregnancy outcomes.It has certain reference value to reduce the adverse pregnancy outcome of pregnant women with gestational diabetes mellitus.