妊娠中晚期GDM患者糖化血红蛋白水平与母婴结局的关系分析

Analysis of the Relationship between Glycosylated Hemoglobin Levels and Maternal and Infant Outcomes in Patients with GDM in the Middle and Late Stages of Pregnancy

目的探讨妊娠中晚期妊娠期糖尿病(GDM)患者糖化血红蛋白(HbA1c)水平与母婴结局的关系。方法选取2019年3月—2020年4月该院收治的90例GDM患者设为观察组,同时选取同期该院收治的90例身体健康非GDM孕妇为对照组。对观察组给予血糖控制,并在分娩前检测HbAlc、空腹血糖(FBG)、餐后2 h血糖(PBG)水平,根据HbAlc水平将其分为达标组和未达标组。对两组孕妇首次检测和终止妊娠期检测的HbAlc、FBG、PBG水平以及不良妊娠结局发生率进行比较,评估不同HbAlc水平孕妇(达标组和未达标组)不良妊娠结局发生率和产后恢复情况。结果两组在终止妊娠期检测的HbA1c、FBG、PBG水平均低于首次检测,且观察组首次检测和终止妊娠期检测HbA1c、FBG、PBG水平均高于对照组,差异有统计学意义(P<0.05);观察组不良妊娠结局发生率为21.11%,明显高于对照组的7.77%,差异有统计学意义(P<0.05);达标组不良妊娠结局发生率为9.25%,显著低于未达标组的38.88%,差异有统计学意义(P<0.05);达标组产后恶露消失时间、子宫恢复时间均明显低于未达标组,差异有统计学意义(P<0.05)。结论HbA1c水平可作为检测GDM孕妇血糖控制的重要指标,并与母婴结局有密切关系,HbA1c水平越高,GDM孕妇不良妊娠结局的发生率也越高,因此在临床上应加强对HbA1c水平的监测,并在产前根据HbA1c水平对GDM孕妇给予合理的饮食、运动、药物等方面的指导,调节控制血糖水平,以此来减少不良妊娠结局发生率。

Objective To explore the relationship between glycosylated hemoglobin(HbA1c)levels and maternal and infant outcomes in Gestational diabetes(GDM)patients in the middle and late stages of pregnancy.Methods 90 cases of GDM patients admitted to the hospital from March 2019 to April 2020 were selected as the observation group,and 90 healthy non-GDM pregnant women admitted to our hospital during the same period were selected as the control group.The observation group was given blood glucose control,and the levels of HbA1c,FBG,and PBG were detected before delivery.According to the level of HbA1c,they were divided into standard group and non-standard group.The HbA1c,FBG,PBG levels and the incidence of adverse pregnancy outcomes were compared between the two groups of pregnant women during the first test and the termination of pregnancy,and the incidence of adverse pregnancy outcomes and postpartum recovery of pregnant women with different HbA1c levels(standard group and non-standard group)were evaluated.Results The levels of HbA1c,FBG and PBG detected during the termination of pregnancy in the two groups were lower than the first detection,and the levels of HbA1c,FBG,and PBG detected during the first detection and termination of pregnancy in the observation group were higher than those in the control group,the difference was statistically significant(P<0.05);The incidence of adverse pregnancy outcomes was 21.11%,which was significantly higher than the control group's 7.77%,the difference was statistically significant(P<0.05);the incidence of adverse pregnancy outcomes in the standard group was 9.25%,which was significantly lower than 38.88%in the non-standard group,the difference was statistically significant(P<0.05);The disappearance time of postpartum lochia and the recovery time of uterus in the group were significantly lower than those in the non-standard group,the difference was statistically significant(P<0.05).Conclusion HbA1c level can be used as an important indicator for the detection of blood glucose control in GDM pregnant women,and was closely related to the maternal and infant outcome.The higher the HbA1c level,the higher the incidence of adverse pregnancy outcomes in GDM pregnant women.Therefore,clinical monitoring of HbA1c levels should be strengthened.The GDM pregnant women should be given reasonable diet,exercise,medication and other guidance based on HbA1c levels before giving birth,adjust and control blood sugar levels,so as to reduce the incidence of adverse pregnancy outcomes.