孕期系统化管理对妊娠期糖尿病妊娠结局影响研究

Study on the Effect of Systematic Management during Pregnancy on Pregnancy Outcome of Gestational Diabetes

目的探讨孕期系统化管理对妊娠期糖尿病(GDM)孕妇妊娠结局的影响。方法方便选取2018年8月-2019年2月在该院规律产检至分娩的110例GDM孕妇作为研究对象,将接受孕期系统化管理、血糖控制满意的68例孕妇纳入观察组,将未接受系统化管理、血糖控制不满意的42例孕妇纳入对照组,对比两组分娩方式、妊娠并发症发生情况和新生儿结局。结果观察组剖宫产率为36.76%,显著低于对照组的52.38%(χ^2=2.587,P<0.05);观察组妊娠期高血压、早产、羊水过多和产后出血发生率分别为2.94%、1.47%、2.94%、4.41%,均显著低于对照组的14.29%、14.29%、16.67%、19.05%(χ^2=4.955、7.156、6.511、6.179,P<0.05),两组胎膜早破发生率相当(χ^2=1.321,P>0.05);观察组巨大儿、红细胞增多症、新生儿低血糖和新生儿窒发生率发生率分别为1.47%、0.00、1.47%、0、0.00%,显著低于对照组的23.81%、9.52%、11.90%、14.29%(χ^2=14.396、6.721、8.481、10.275,P<0.05)。结论孕期系统化管理在GDM孕妇中的应用,可显著降低剖宫产率,减少妊娠期并发症,改善新生儿结局。

Objective To investigate the effect of systematic management during pregnancy on pregnancy outcomes in pregnant women with gestational diabetes mellitus (GDM). Methods A total of 110 pregnant women with GDM who were routinely examined and delivered to our hospital from August 2018 to February 2019 in our hospital were enrolled. 68 pregnant women who were systematically managed during pregnancy and satisfied with glycemic control were included in the observation group. Forty-two pregnant women who were systematically managed and unsatisfied with glycemic control were included in the control group, comparing the two groups of delivery methods, pregnancy complications and neonatal outcomes. Results The cesarean section rate of the observation group was 36.76%, which was significantly lower than that of the control group 52.38%(χ^2=2.587, P<0.05). The incidence of hypertension, premature delivery, polyhydramnios and postpartum hemorrhage in the observation group was 2.94%, 1.47%, 2.94%, and 4.41% were significantly lower than 14.29%, 14.29%, 16.67%, and 19.05% of the control group (χ^2=4.955, 7.156, 6.511, 6.179, P<0.05). The incidence of breakage was comparable (χ^2=1.321, P>0.05);the incidence of macrosomia, polycythemia, neonatal hypoglycemia and neonatal spasticity in the observation group were 1.47%, 0.00%, 1.47%, 0, 0.00%, respectively, lower than that of the control group of 23.81%, 9.52%, 11.90%, and 14.29% lower than the control group (χ^2=14.396, 6.721, 8.481, 10.275, P<0.05). Conclusion The systematic management of pregnancy in pregnant women with GDM can significantly reduce the rate of cesarean section, reduce complications during pregnancy, and improve neonatal outcomes.