妊娠合并糖尿病孕产妇不同时期加用胰岛素治疗对妊娠结局的影响

Effects of Additional Insulin Therapy on Pregnancy Outcomes in Pregnant Women with Diabetes Mellitus during Pregnancy

目的 探讨于不同时期采用胰岛素对妊娠合并糖尿病孕产妇进行治疗对其妊娠结局产生的影响。方法 选取2016年1月—2020年12月华南理工大学附属第二医院收治的80例妊娠合并糖尿病孕产妇,随机分为参照组(于孕32周后采用胰岛素治疗)和研究组(于孕32周前采用胰岛素治疗),各40例;比较两组孕产妇妊娠结局(剖宫产、早产、产后出血/感染、妊娠合并高血压)、血糖水平(空腹血糖、餐后2 h血糖)、新生儿并发症(新生儿窒息、新生儿低血糖、巨大儿、低体重儿)发生率。结果 研究组剖宫产、早产、产后出血/感染、妊娠合并高血压发生率均低于参照组,差异有统计学意义(P<0.05);治疗前,研究组空腹血糖(7.29±1.47)mmol/L、餐后2 h血糖(5.19±1.17)mmol/L同参照组(7.32±1.48)mmol/L、(5.23±1.18)mmol/L比较,差异无统计学意义(P>0.05);治疗后,研究组空腹血糖(5.19±1.17)mmol/L、餐后2 h血糖(7.09±1.35)mmol/L均低于参照组(5.99±1.29)mmol/L、(8.01±1.49)mmol/L,差异有统计学意义(P<0.05);研究组新生儿窒息、新生儿低血糖、巨大儿、低体重儿发生率均低于参照组,差异有统计学意义(P<0.05)。结论 于孕32周前采用胰岛素对妊娠合并糖尿病患者进行治疗,可显著提高血糖水平,显著降低剖宫产、早产、产后出血/感染、妊娠合并高血压、新生儿窒息、新生儿低血糖、巨大儿、低体重儿发生率,提升妊娠合并糖尿病孕产妇总体预后水平。

Objective To investigate the effect of insulin therapy on pregnancy outcomes of pregnant women with diabetes mellitus in different periods.Methods Methods 80 pregnant women with diabetes who were admitted to the Second Affiliated Hospital of South China University of Technology from January 2016 to December 2020 were randomly divided into the reference group(treated with insulin after 32 weeks of gestation) and the study group(treated with insulin before 32 weeks of gestation),with 40 cases in each group.The incidence of pregnancy outcomes(cesarean section,premature delivery,postpartum hemorrhage/infection,pregnancy with hypertension),blood glucose levels(fasting blood glucose,2 h postprandial blood glucose),and neonatal complications(neonatal asphyxia,neonatal hypoglycemia,macrosomia,and low birth weight) were compared between the two groups.Results The incidences of cesarean section,premature birth,postpartum hemorrhage/infection,and pregnancy-related hypertension in the study group were lower than those in the reference group,the difference was statistically significant(P0.05).After treatment,the fasting blood glucose(5.19±1.17) mmol/L and the2 h postprandial blood glucose(7.09±1.35) mmol/L of the study group were lower than those of the reference group(5.99±1.29) mmol/L and(8.01±1.49) mmol/L,the difference was statistically significant(P<0.05).The incidences of neonatal asphyxia,neonatal hypoglycemia,macrosomia and low birth weight infants in the study group were lower than those in the reference group,the difference was statistically significant(P<0.05).Conclusion At 32 weeks ago in using insulin treatment in patients with gestational diabetes mellitus,can significantly improve the level of blood sugar,significantly reduce the cesarean section,premature delivery,postpartum hemorrhage/infection,gestational hypertension,neonatal asphyxia,neonatal hypoglycemia,macrosomia,incidence of low birth weight,enhance the level of maternal pregnancy with diabetes overall prognosis.