孕前漏诊的孕前糖尿病的临床特点及对妊娠结局的影响

Clinical Features of Misdiagnosed Pre-pregnancy Diabetes Patients before Pregnancy and Effect on the Gestational Outcome

目的探讨孕前漏诊孕前糖尿病临床特点及对妊娠结局的影响。方法选取2017年10月—2018年7月于该院分娩并确诊为PGDM的130例孕妇作为研究对象,根据不同诊断时间点进行分组,将血糖升高时是否妊娠作为标准,分为孕前诊断组、孕期诊断组,分别为52例、78例。回顾性分析孕妇分娩年龄、分娩孕周、分娩方式、PGDM诊断时间点、使用胰岛素及新生儿结局等临床资料,比较两组孕妇不良妊娠结局发生情况。结果孕前诊断组占40.00%(52/130),孕期诊断组占60.00%(78/130),PGDM孕前漏诊率为60.00%。两组早产、巨大儿比较差异无统计学意义(P>0.05),而在剖宫产、使用胰岛素、子痫前期等方面比较差异有统计学意义(P<0.05)。结论通过加强孕前、妊娠早期血糖筛查工作对早期发现漏诊PGDM具有重要意义,可有效改善不良妊娠结局,促进母婴健康。

Objective To study the clinical features of misdiagnosed pre-pregnancy diabetes patients before pregnancy and effect on the gestational outcome.Methods 130 cases of delivery women confirmed with PGDM in our hospital from October 2017 to July 2018 were selected as the research objects and divided into groups according to different diagnosis time points,according to whether the hyperglycemia existed or not,and the patients were divided into 52 cases in the pre-pregnancy diagnosis group and78cases in the pregnancy diagnosis group,and the delivery age,delivery gestational week,delivery way,PGDM diagnosis time pint,usage of insulin and outcomes of newborns were retrospectively analyzed,and the occurrence of adverse pregnancy outcomes was compared between the two groups.Results The ratios in the pre-pregnancy diagnosis group and in the pregnancy diagnosis group were respectively 40.00%(52/130)and 60.00%(78/130),and the PGDM pre-pregnancy missed diagnosis rate was 60.00%,and the differences in the premature birth and macrosomia between the two groups were not statistically significant(P>0.05),and the differences in the cesarean section,insulin usage and preeclampsia between the two groups were statistically significant(P<0.05).Conclusion The enhancement of pre-pregnancy and early gestational blood glucose screening work are of important significance to the early discovery of missed diagnosis of PGDM,and it can effectively improve the adverse gestational outcome and promote the maternal and infant health.