妊娠期糖尿病孕妇年龄与围生期结局关系

Relationship between the age of pregnant women with gestational diabetes mellitus and their perinatal outcomes

目的:探讨妊娠期糖尿病(GDM)孕妇年龄与妊娠高危因素和围生期结局关系。方法:回顾性收集2017年1月—2019年12月阜阳市人民医院分娩的妊娠期糖尿病孕妇1142例临床资料,按分娩年龄分组,年龄<30岁组439例、30~34岁组323例、≥35岁组380例。分析各组GDM孕妇一般临床情况及血糖、围生期结局等。结果:空腹血糖、糖尿病家族史3组间无差异,孕前体质指数(BMI)和应用胰岛素治疗比例<30岁组小于30~34岁组和≥35岁组,各组子痫前期发病率存在差异(均P<0.05);孕前BMI≥24 kg/m2和餐后2h血糖过高是导致巨大儿发生的高危因素。结论:GDM孕妇中,高龄孕妇更易并发子痫前期,孕前肥胖及餐后2h血糖水平影响胎儿体重。

Objective:To discuss the relationship between the age of pregnant women with gestational diabetes mellitus(GDM)and their pregnancy risk factors and perinatal outcomes.Methods:The clinical data of 1,142 pregnant women with GDM from January 2017 to December 2019 were collected retrospectively.According to the age of these women,they were divided into group A(439 women with<30 years old),group B(323 women with 30-34 years old),and group C(380 women with≥35 years old).The general conditions,blood glucose level,and perinatal outcomes of the women among the three groups were analyzed.Results:There were no significant differences in fasting blood glucose level and the family history of diabetes of the women among the three groups.BMI value before pregnancy and the proportion of insulin treatment of the women in group A were significant lower than those of the women in group B and C.There was significant difference in the incidence of preeclampsia among pregnant women with GDM in different delivery age(all P<0.05).BMI value≥24 kg/m2 before pregnancy and high blood glucose level at postprandial 2 h were the high risk factors of macrosomia.Conclusion:The obesity before pregnancy and high blood glucose level at postprandial 2 h of pregnant women with GDM will affect their fetal weight,especially for those advanced women.