妊娠期糖尿病孕妇血糖控制水平及对母婴妊娠结局的影响

Blood glucose control level of pregnant women with gestational diabetes mellitus and the effect on maternal and infant pregnancy outcome

目的探讨妊娠期糖尿病(GDM)孕妇血糖控制水平及其对母婴妊娠结局的影响。方法对374例确诊的GDM孕妇进行随访研究,根据其血糖控制达标情况分为控制良好组228例和控制不良组146例,比较两组孕妇血糖水平、妊娠并发症发生率、围生儿并发症发生率等指标。结果治疗后374例GDM孕妇中血糖控制不良发生率为39.04%(146/374);控制不良组孕妇治疗后的FPG、2 hPBG及HbA1c水平均明显高于控制良好组,妊娠期高血压疾病、羊水过多、胎膜早破、产后出血、产褥感染、胎儿窘迫、巨大儿、早产儿、新生儿窒息、新生儿低血糖等并发症发生率均高于控制良好组,差异均有统计学意义(P<0.05)。结论 GDM孕妇通过治疗后仍有较高的血糖控制不良发生率,血糖控制不良容易产生各种妊娠并发症和围生儿并发症,影响母婴妊娠结局。

Objective To explore blood glucose control level of pregnant women with gestational diabetes mellitus(GDM)and the effect on maternal and infant pregnancy outcome.Methods A total of 374 pregnant women with GDM were followed up and divided into well-controlled group(228 cases)and poor-control group(146 cases)according to blood glucose control level.Blood glucose levels,incidence rates of pregnancy complications and perinatal complications were compared between the two groups.Results After treatment,the incidence rate of poor blood glucose control was 39.04%(146/374).After treatment,FPG,2 hPBG,and HbA1c levels in poor-control group were statistically significantly higher than those in well-controlled group,the incidence rates of hypertensive disorders of pregnancy,polyhydramnios,premature rupture of membranes,postpartum hemorrhage,puerperal infection,fetal distress,macrosomia,premature infant,neonatal asphyxia,and neonatal hypoglycemia in poor-control group were statistically significantly higher than those in well-controlled group(P<0.05).Conclusion After treatment,the incidence rate of poor blood glucose control is still high in pregnant women with GDM,poor blood glucose control can induce pregnancy complications and perinatal complications,affect maternal and infant pregnancy outcome.