妊娠期糖尿病孕妇血糖控制情况与围产结局关系探讨

Study on the relationship between blood glucose level controlled of pregnant woman with gestational diabetes mellitus and their perinatal outcomes

目的:探讨妊娠期糖尿病(GDM)孕妇血糖控制对新生儿结局的影响。方法:收集2017年4月—2019年7月本院妇产科收治的GDM孕妇临床资料97例,统计孕期血糖控制情况并比较控制良好或不良产妇孕期总增重、每周增重、体质指数(BMI),围产期并发症和新生儿并发症情况。结果:97例GDM孕产妇中,血糖控制良好54例(55.7%),控制不良43例(44.3%),两组产妇年龄、孕周、孕次、身高比较未见差异(P>0.05);血糖控制良好组孕期总增重、体重增长、BMI增长均低于控制不良组(P<0.05),围生期感染率未见差异(P>0.05);控制良好组产后出血(1.9%)、胎膜早破(3.7%)、剖宫产(18.5%)及妊娠期高血压疾病率(1.9%)均低于控制不良组(P<0.05);血糖控制良好组低血糖(3.7%)、新生儿窒息(5.6%)、巨大儿发生率(1.9%)低于血糖控制不良组(P<0.05),畸形儿(5.6%)、死亡/死胎(1.9%)与控制不良组无差异(P>0.05)。结论:GDM孕妇血糖水平控制良好母婴结局较佳,科学合理、持续的控糖干预可使孕妇从中受益,改善不良结局。

Objective:To explore the effect of blood glucose level controlled of pregnant woman with gestational diabetes mellitus(GDM)on their outcomes of newborns.Method:The clinical data of 97 pregnant women with GDM from April 2017 to July 2019 were collected.The blood glucose level controlled situation of these women during pregnancy was statistics analyzed.The total weight gain during pregnancy,weekly weight gain,body mass index(BMI)value,and the perinatal complications rate of the women,and neonatal complications situation were compared between the women with good blood glucose level controlled(in group A)and the women with poor blood glucose level controlled(in group B).Results:In the 97 pregnant women with GDM,54(55.7%)women with good blood glucose level controlled,and 43(44.3%)women with poor blood glucose level controlled.There were no significant differences in maternal age,gestational weeks,times of pregnancy,and height of the women between the two groups(P>0.05).The total weight gain,weekly weight gain,and BMI increase during pregnancy of the women in group A were significant lower than those of the women in group B(P<0.05),there was no significant difference in the rate of perinatal infection of the women between the two groups(P>0.05).The rates of postpartum hemorrhage(1.9%),premature rupture of membranes(3.7%),cesarean section(18.5%),and pregnancy hypertension(1.9%)of the women in group A were all significant lower than those of the women in group B(P<0.05).The incidence of hypoglycemia of the women(3.7%),and the incidences of neonatal asphyxia(5.6%)and macrosomia(1.9%)in group A had no significant different from those in group B(P>0.05).Conclusion:Maternal and infant outcomes of GDM pregnant women with good blood glucose level controlled are better.So scientific,reasonable and continuous controlling blood glucose level can benefit for pregnant women with GDM,which can improve their pregnancy outcomes.