孕期综合干预对妊娠期糖尿病高危孕妇妊娠结局的影响

Influence of Comprehensive Intervention During Pregnancy on Pregnancy Outcomes of Pregnant Women at High Risk of Gestational Diabetes Mellitus

目的 观察孕期综合干预对妊娠期糖尿病高危孕妇妊娠结局的影响。方法 选取2019年1月—2021年12月太仓市中医医院诊治的妊娠期糖尿病高危孕妇284例,随机分为观察组及对照组,各142例。对照组实施常规门诊干预,观察组实施孕期综合干预,观察两组血糖参数、孕产妇并发症、围产儿结局。结果 两组初次孕检时血糖参数差异无统计学意义(P>0.05);观察组分娩前FPG(4.90±0.49)mmol/L、2 hPG(7.40±0.65)mmol/L、HbA1c(6.32±0.64)%低于对照组,差异有统计学意义(P<0.05)。观察组羊水过多(1.41%)、软产道裂伤(10.56%)、妊娠期糖尿病(7.04%)、胎膜早破(2.11%)、剖宫产(28.17%)、产后出血(0.70%)、感染(1.41%)占比低于对照组,差异有统计学意义(P<0.05)。观察组早产儿(1.41%)、新生儿窒息(0.70%)、巨大儿(4.23%)、新生儿低血糖(1.41%)、高胆红素血症(14.08%)、胎儿生长受限(1.41%)占比低于对照组,差异有统计学意义(P<0.05)。结论 综合干预能稳定妊娠期糖尿病高危孕妇血糖水平,减少母婴并发症。

Objective To observe the effect of comprehensive intervention during pregnancy on pregnancy outcomes of pregnant women with high risk of gestational diabetes mellitus.Methods A total of 284 pregnant women with high risk of gestational diabetes mellitus diagnosed and treated in Taicang Traditional Chinese Medicine Hospital from January 2019 to December 2021 were selected.They were randomly divided into observation group and control group,each with 142 cases.The control group was given routine outpatient intervention,and the observation group was given comprehensive pregnancy intervention.The blood glucose parameters,maternal complications and perinatal outcomes were observed in the two groups.Results There was no statistically significant difference in blood glucose parameters between the two groups of pregnant women during the first pregnancy examination(P>0.05).The FPG(4.90±0.49)mmol/L,2 hPG(7.40±0.65)mmol/L,and HbA1c(6.32±0.64)%of the observation group were lower than those of the control group before delivery,and the difference was statistically significant(P<0.05).In the observation group,polyhydramnios(1.41%),soft birth canal laceration(10.56%),gestational diabetes mellitus(7.04%),premature rupture of membranes(2.11%),cesarean section(28.17%),postpartum hemorrhage(0.70%)and the proportion of infection(1.41%)were lower than that of the control group,and the difference was statistically significant(P<0.05).In the observation group,premature infants(1.41%),neonatal asphyxia(0.70%),macrosomia(4.23%),neonatal hypoglycemia(1.41%),hyperbilirubinemia(14.08%),fetal growth restriction(1.41%)%)were lower than that of the control group, and the difference was statistically significant (P<0.05).Conclusion Comprehensive intervention can stabilizethe blood glucose level of pregnant women with high risk of gestational diabetes mellitus, reduce the complications ofmother and child.