妊娠期糖尿病患者血糖控制水平与不良妊娠结局的关系分析

Analysis of relationship between blood glucose control and adverse pregnancy outcomes among pregnant women with gestational diabetes mellitus

目的探讨妊娠期糖尿病患者血糖水平控制与不良妊娠结局的关系。方法纳入东莞市第八人民医院2017年7-12月确诊为妊娠期糖尿病的产妇343例,其中180例产妇严格定期产前检测,患者依从性好,在医护人员指导下接受规范化管理治疗,设为血糖控制满意组;另外163妊娠糖尿病患者依从性差,饮食未得到控制,未按规范化管理治疗,不按照医嘱执行,设为血糖控制不满意组。分析产前血糖水平控制对不良妊娠结局的影响。结果血糖控制满意组与不满意组比较,早产、胎儿宫内窘迫、剖宫产、难产、大于胎龄儿、低体重儿、新生儿窒息、新生儿低血糖、新生儿高胆红素血症差异有统计学意义(P<0.05);妊娠期糖尿病对妊娠结局不良影响的Logistic回归分析显示,家族史、孕前体重指数、孕期血糖控制不良、孕期运动是妊娠期糖尿病发生的危险因素。结论妊娠期糖尿病发生的影响因素很多,血糖控制良好可减少孕妇与胎儿的并发症,改善妊娠期糖尿病的不良妊娠结局。

Objective To investigate the relationship between blood glucose control and adverse pregnancy outcome among patients with gestational diabetes. Methods A total of 343 pregnant women with gestational diabetes diagnosed from July 2017 to December2017 in our hospital were enrolled. Among them,180 pregnant women who had good compliance and were monitored strictly during antenatal examination,and received standard treatment were selected as the satisfied blood glucose control group. The other 163 gestational diabetes patients with poor compliance,not controlled diet,not according to standardized management and treatment,not in accordance with the doctor＇s advice were selected as unsatisfied blood glucose control group. The effect of prenatal blood glucose control on adverse pregnancy outcomes was analyzed. Results There were statistically significant differences in the rates of premature delivery,fetal distress,cesarean section,dystocia,greater than gestational age,low birth weight,neonatal asphyxia,neonatal hypoglycemia and neonatal hyperbilirubinemia between the two groups（ P〈0. 05）. The logistic regression analysis of the adverse effects of gestational diabetes on pregnancy outcomes revealed that family history,pre-pregnancy body mass index,poor control of blood sugar during pregnancy and exercises during pregnancy were the risk factors for gestational diabetes. Conclusion There are many factors that affect the occurrence of gestational diabetes. Good blood glucose control can reduce the complications of pregnant women and fetus and improve the adverse pregnancy outcome of gestational diabetes.