妊娠期糖尿病孕妇的早期规范化管理对分娩新生儿及其随访的影响

Effects of Early Standardized Management of Pregnant Women with Gestational Diabetes on Delivery of Newborns and Follow-up

目的研究早期规范化管理对妊娠期糖尿病孕妇分娩新生儿出生情况及后续生长发育情况的影响。方法采用方便抽样法从2015年1月-2018年1月在该院出生的新生儿中抽选106名作为研究对象,根据新生儿母亲孕期是否被确诊为妊娠期糖尿病分为研究组53例(妊娠期糖尿病)和对照组53名(非妊娠期糖尿病),且研究组新生儿及其母亲接受早期规范化管理和随访,对照组新生儿及其母亲则接受常规管理和随访,收集两组新生儿及其母亲的一般临床资料、新生儿出生后3个月内的喂养方式及随访至2岁时的生长发育情况,并进行组间比较。结果研究组与对照组新生儿一般临床资料及新生儿母亲年龄、生产情况及分娩方式比较,差异无统计学意义(χ^2=0.038,1.093,1.889,0.173,0.204,0.384,P>0.05);研究组中孕前体质指数<18.5 kg/m^213.21%、18.5~24.0 kg/m^258.49%、≥24.0 kg/m^228.30%与对照组26.42%、64.15%、9.43%比较(χ^2=7.472,P<0.05);研究组中纯母乳喂养71.70%、混合喂养20.76%、人工喂养7.55%与对照组75.47%、18.87%、5.66%比较,差异无统计学意义(χ^2=0.242,P>0.05);两组随访至2岁时的研究组身高(82.13±3.45)cm、体重(11.27±1.69)kg、头围(47.03±1.49)cm、发育商(95.69±5.84)分、大运动(24.07±2.37)月、精细运动(23.30±2.16)月与对照组(82.26±3.51)cm、(11.32±1.70)kg、(47.10±1.54)cm、(96.21±5.96)分、(24.16±2.41)月、(23.41±2.22)月比较,差异无统计学意义(t=0.192,0.152,0.238,0.454,0.194,0.259,P>0.05),但研究组适应能力(24.63±2.48)个月、语言能力(21.51±2.59)个月、社交行为(21.96±2.36)个月,与对照组(26.59±2.62)个月、(23.63±2.67)个月、(22.97±2.44)个月比较差异有统计学意义(t=3.955,4.149,2.166,P<0.05)。结论早期规范化管理可以改善妊娠期糖尿病孕妇分娩新生儿出生情况,且可促进母乳喂养,利于新生儿体格的正常发育,但妊娠期糖尿病孕妇分娩新生儿还存在神经心理发育有所受限的问题,相关工作者必须予以重视,以便促进妊娠期糖尿病孕妇分娩新生儿的全面发展。

Objective To study the effects of gestational diabetes mellitus pregnant women’searly standardized management in neonatal outcomes and growth.Methods By stratified sampling method from January 2015 to January 2018 in the hospital was born in the newborns selected 106 cases as the research object,according to new mothers during pregnancy has been diagnosed with gestational diabetes are convenient divided into research group and 53 cases(gestational diabetes)and control group 53 cases(gestational diabetes),and the team the standardized management of newborn babies and their mother accept early and follow-up,control the newborn and his mother received routine management and follow-up,to collect general clinical data of two groups of newborns and their mothers,within 3 months after birth way of feeding and growth and development situation of follow-up to 2 years of age,and compare between groups.Results There was no statistically significant difference in the general clinical data of neonates between the study group and the control group,as well as the neonatal mother’s age,birth conditions and delivery methods(χ^2=0.038,1.093,1.893,0.173,0.204,0.384,P>0.05);the study group Body mass index before mid-pregnancy<18.5 kg/m^213.21%,18.5-24.0 kg/m^258.49%,≥24.0 kg/m^228.30%compared with the control group 26.42%,64.15%,9.43%(χ^2=7.472,P<0.05);In the study group,exclusive breastfeeding 71.70%,mixed feeding 20.76%,artificial feeding 7.55%and control group 75.47%,18.87%,5.66%,the difference was not statistically significant(χ^2=0.242,P>0.05);the two groups were followed up until At the age of 2 years,the study group’s height(82.13±3.45)cm,weight(11.27±1.69)kg,head circumference(47.03±1.49)cm,development quotient(95.69±5.84)points,major exercise(24.07±2.37)months,fine Exercise(23.30±2.16)months and control group(82.26±3.51)cm,(11.32±1.70)kg,(47.10±1.54)cm,(96.21±5.96)minutes,(24.16±2.41)months,(23.41±2.22)Monthly comparison,the difference was not statistically significant(t=0.192,0.152,0.238,0.454,0.194,0.259,P>0.05),but the study group’s adaptability(24.63±2.48)months,language ability(21.51±2.59)months,social Behavior(21.96±2.36)months,compared with control group(26.59±2.62)months,(23.63±2.67)months,(22.97±2.44)months,the difference was statistically significant(t=3.955,4.149,2.166,P<0.05).Conclusion For gestational diabetes mellitus pregnant women,the early standardized management can promote the breast feeding,and improve the neonatal outcomes and physical development.However,the newborn’s neuropsychological development issues shall be focused.