新妊娠期糖尿病诊断标准实施管理在围产儿结局中的作用

The Role of Management of Diagnostic Criteria for New Gestational Diabetes in Perinatal Outcomes

目的探究新妊娠期糖尿病诊断标准实施管理在围产儿结局中的作用。方法回顾性分析2015年1月—2016年12月于该院分娩的产妇174例,其中2015年度收治的87例按旧妊娠期糖尿病诊断标准进行筛查管理的产妇作为参照组,2016年度收治的87例按照新妊娠期糖尿病诊断标准施行管理的产妇作为观察组,对比两组产妇妊娠结局及新生儿并发症情况。结果观察组妊娠期糖尿病检出率17.24%显著高于参照组3.45%,差异有统计学意义(χ~2=8.823 1;P=0.002 8);与对照组相比,观察组产妇胎膜早破率显著更低,差异有统计学意义(χ~2=3.965 8,P=0.046 4),剖宫产率显著更低,差异有统计学意义(χ~2=8.034 6,P=0.004 6);但羊水过多、并发妊娠期高血压、羊膜腔感染、产后出血等与参照组相比差异无统计学意义(χ~2=0.0339 2、0.144 8、2.023 3、0.205 9,P=0.560 3、0.699 6、0.154 9、0.645 0)。观察组巨大儿比例显著低于参照组,差异有统计学意义(χ~2=11.575 9,P=0.000 7);而低体重儿、新生儿低血糖、新生儿呼吸窘迫综合症、新生儿肺炎、新生儿高胆红素血症等与参照组相比差异无统计学意义(χ~2=1.0058、1.005 8、1.005 8、0.690 5、0.358 0,P=0.315 9、0.315 9、0.315 9、0.406 0、0.549 6)。结论新妊娠期糖尿病诊断标准下进行妊娠期糖尿病管理能有效改善围产儿妊娠结局。

Objective To investigate the role of the implementation of management criteria for new gestational diabetes in perinatal outcomes. Methods A retrospective analysis of 174 women who gave birth in the hospital from January 2015 to December 2016, including 87 women who were screened for the diagnosis of old gestational diabetes in 2015, as the refer- ence group, 87 eases were treated in 2016. The maternal management of the diagnostic criteria for gestational diabetes was used as an observation group to compare the maternal pregnancy outcomes and neonatal complications. Results The detec- tion rate of gestational diabetes in the observation group was 17.24% significantly higher than that in the reference group of 3.45%,the different was statistically significant（x2=8.823 1; P=0.002 8）. Compared with the control group, the rate of prema- ture rupture of membranes was significantly lower in the observation group,the different was statistically significant（x2=3.965 8, P=0.046 4）, cesarean section rate was significantly lower,the different was statistically significant （X2=8.034 6, P=0.004 6）; however, there was no significant difference in amniotic fluid, concurrent gestational hypertension, amniotic infection, postpartum hemorrhage, etc. compared with the reference group （X2= 0.339 2, 0.144 8, 2.023 3, 0.205 9, P=0.560 3, 0.699 6, 0.154 9, 0.645 0）. The proportion of large children in the observation group was significantly lower than that in the reference group,the different was statistically significant（x2=1 1.575 9, P=0.000 7）; while low birth weight, neonatal hypoglycemia, neonatal respiratory distress syndrome, neonatal pneumonia, neonatal hyperbilirubinemia, etc. There was no significant dif- ference compared to the reference group （X2=1.005 8, 1.005, 1.05 8, 0.690 5, 0.358 0, P=0.315 9, 0.315 9, 0.315 9, 0.406 0,0.549 6）. Conclusion The management of gestational diabetes under the diagnostic criteria of new gestational diabetes can effectively improve the outcome of perinatal pregnancy.