糖化血红蛋白水平对妊娠期糖尿病患者母婴结局的影响

Effect of glycated hemoglobin level on maternal-fetal outcome in patients with gestational diabetes

目的探讨糖化血红蛋白(HbAlC)水平对妊娠期糖尿病患者妊娠结局和新生儿结局的影响。方法选取2016年7月~2018年6月来我院检查且确诊为妊娠期糖尿病患者205例,根据其产前HbAlC水平进行分组。将分娩期4.0%≤HbAlC<6.0%者设定为达标组,共117例,另将HbAlC≥6.0%者设定为未达标组,共88例。比较两组的妊娠结局和新生儿结局。结果达标组妊娠期高血压病、子痫前期、羊水过多、胎膜早破、剖宫产发生率及产前BMI均明显低于未达标组,妊娠周数明显高于未达标组,差异有统计学意义(P<0.05)。达标组早产儿、巨大儿、新生儿低血糖、新生儿窒息和高胆红素血症发生率均分别低于未达标组,新生儿1minApgar评分、体重均分别高于未达标组,差异有统计学意义(P<0.05)。结论妊娠期糖尿病患者的HbAlC水平和母婴结局关系密切,对妊娠结局和新生儿结局影响较大,故可作为孕妇血糖控制的重要监测指标。

Objective To investigate the effects of glycated hemoglobin (HbAlC) levels on pregnancy outcome and neonatal outcome in patients with gestational diabetes mellitus. Methods 205 patients with gestational diabetes mellitus who were admitted to our hospital from July 2016 to June 2018 were selected according to their prenatal HbAlC levels.The delivery period of 4.0%≤ HbAlC < 6.0% was set as the compliance group,a total of 117 cases,and another HbAlC ≥ 6.0% were set as non-standard group,a total of 88 cases.Pregnancy outcomes and neonatal outcomes were compared between the two groups. Results Hypertension,gestational premature eclampsia,premature rupture of membranes,premature rupture of membranes,cesarean section and prenatal BMI were significantly lower in the standard group than in the non-standard group.The number of weeks of pregnancy was significantly higher than that in the non-standard group.The difference was statistically significant (P < 0.05).The prevalence of preterm infants,macrosomia,neonatal hypoglycemia,neonatal asphyxia and hyperbilirubinemia in the standard group were lower than those in the non-standard group.The 1 min Apgar score and body weight of the newborn were higher than those of the non-standard group,and the difference was statistically significant (P < 0.05). Conclusion The level of HbAlC in patients with gestational diabetes is closely related to maternal and fetal outcomes,and has a greater impact on pregnancy outcomes and neonatal outcomes,so it can be used as an important monitoring indicator for glycemic control in pregnant women.