基于大数据分析的妊娠期糖尿病孕期远程管理对母婴结局的影响

The influence of remote management of gestational diabetes mellitus on maternal and infant outcomes based on large data analysis

目的探讨基于大数据分析的妊娠期糖尿病孕期远程管理对妊娠结局的影响。方法选取深圳市南山区妇幼保健院2017年5～12月间孕12周前建册并于孕24～28周确诊为妊娠期糖尿病的孕妇120例为研究对象,根据孕期管理模式差异,分为孕期远程管理组和传统孕期管理组,各60例,同时,随机抽取同期分娩的血糖正常孕妇60例为对照组,观察并比较3组患者血糖控制水平、胎心监护情况及母婴结局。结果孕期远程管理组孕妇空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(postprandial 2 h blood glucose,PBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)水平均低于传统孕期管理组,差异有统计学意义(P<0.05),与对照组比较差异无统计学意义(P>0.05);孕期远程管理组孕妇基础胎心率、胎动次数、胎心率变异、胎心率加速次数显著升高,差异有统计学意义(P<0.05),孕期远程管理组与对照组相比,两组孕妇基础胎心率、胎心率变异、胎心率加速次数间差异无统计学意义(P>0.05);孕期远程管理组剖宫产、胎膜早破、产后出血、妊娠期高血压疾病、早产儿、巨大儿、新生儿窒息的例数均低于传统孕期管理组,差异有统计学意义(P<0.05),且与对照组相比,各项母婴结局指标间差异无统计学意义(P>0.05)。结论基于大数据分析的妊娠期糖尿病孕期远程管理可有效改善孕妇的血糖控制水平,促进胎心率维持正常水平,减少不良妊娠结局的发生。

Objective To explore the effect of remote management of gestational diabetes mellitus(GDM) on pregnancy outcome based on large data analysis. Methods 120 pregnant women who were diagnosed with GDM in the 24~28 weeks of pregnancy in Shenzhen Nanshan Women and Children Health Care Hospital from May 2017 to December 2017 were selected and divided into the remote pregnancy management group and the traditional pregnancy management group, 60 cases each group, according to the differences in the management mode of pregnancy. Meanwhile, 60 pregnant women with normal blood glucose during the same period were randomly selected as control group. The levels of blood glucose control, fetal heart rate monitoring and maternal and neonatal outcomes were observed and compared between the three groups. Results The levels of fasting blood glucose(FBG), postprandial 2 h blood glucose(PBG) and glycosylated hemoglobin(HbA 1 c) in the remote pregnancy management group were significantly lower than those of the traditional pregnancy management group(P<0.05), and there was no significant difference compared with the control group(P>0.05). The basic fetal heart rate(FHR),and fetal movement, the fetal heart rate variation and fetal heart rate acceleration times of the remote pregnancy management group were significantly higher than that of the traditional pregnancy management group(P<0.05). Compared with the control group, there was no significant difference in the basic fetal heart rate, the fetal heart rate variation and the fetal heart rate acceleration times between the two groups(P>0.05). The number of cesarean section, premature rupture of fetal membranes, postpartum hemorrhage, pregnancy induced hypertension, preterm infants, preterm infants, neonatal asphyxia and neonatal asphyxia in the remote pregnancy management group were significantly lower than those of the traditional pregnancy management group(P<0.05). Compared with the control group, there was no statistically significant difference between the maternal and infant outcome indicators(P>0.05). Conclusion Remote management of gestational diabetes based on large data analysis can effectively improve the level of blood glucose control in pregnant women, promote the normal fetal heart rate and reduce the incidence of bad pregnancy.