新诊断标准下妊娠期糖尿病产妇所生新生儿结局分析

Analysis of neonatal outcomes in pregnant women with gestational diabetes mellitus under new diagnostic criteria

目的了解国际糖尿病与妊娠研究组(IADPSG)妊娠期糖尿病(GDM)新诊断标准下GDM产妇所生新生儿的临床结局。方法 549例确诊GDM的单胎产妇为GDM组,同期550例无妊娠合并症的单胎产妇为对照组。比较两组产妇所生新生儿的临床结局。结果两组产妇的新生儿早产发生率、小于胎龄儿发生率、巨大儿发生率、出生体质量指数比较,差异均无统计学意义(χ~2=0.371、0.315、2.407,t=0.753,P>0.05);GDM组产妇的新生儿大于胎龄儿发生率高于对照组,差异具有统计学意义(χ~2=13.600,P<0.05)。两组产妇的新生儿高胆红素血症、新生儿低血糖、新生儿肺炎、1 min阿氏评分≤7分发生率比较,差异均无统计学意义(χ~2=0.287、0.069、0.000、0.914,P>0.05)。结论新诊断标准更好地识别GDM高危产妇,通过对产妇孕期的干预及对其新生儿的密切监护等综合措施改善了新生儿不良结局。

Objective To understand the clinical outcomes of newborns in pregnant women withgestational diabetes mellitus(GDM)under new diagnostic criteria of International Association of Diabetes andPregnancy Study Group(IADPSG).Methods There were549singleton pregnant woman with confirmed GDMas GDM group,and concurrent550singleton pregnant woman with no pregnancy complications as the controlgroup.The clinical outcomes of newborns in two groups were compared.Results Both groups had no statisticallysignificant difference in incidence of premature birth,incidence of small for gestational age newborns,macrosomiarate and birth weight index(χ2=0.371,0.315,2.407,t=0.753,P>0.05).GDM group had higher incidence of largefor gestational age newborns than the control group,and the difference was statistically significant(χ2=13.600,P<0.05).Both groups had no statistically significant difference in incidence of neonatal hyperbilirubinemia,neonatal hypoglycemia,neonatal pneumonia and1minute A score≤7points(χ2=0.287,0.069,0.000,0.914,P>0.05).Conclusion The new diagnostic criteria can better identify GDM high-risk parturient,and improve theneonatal adverse outcomes through comprehensive measures of maternal intervention during pregnancy and closemonitoring of their newborns.