妊娠期糖尿病筛查以及早期干预对母婴的影响

Screening for Gestational Diabetes and the Impact of Early Intervention on Mothers and Infants

目的探究实施妊娠期糖尿病筛查及早期干预对母婴结局产生的影响。方法选取2019年5月—2022年5月于扬州市江都妇幼保健院产检并分娩的78例妊娠期糖尿病孕妇作为研究对象。所有对象均于28孕周前予以妊娠期糖尿病筛查并确诊,依据对孕妇实施干预时间区别予以分组,将39例妊娠后期(28周后)干预的糖尿病孕妇作为对照组,将39例妊娠中期(24~28周)干预的糖尿病孕妇作为观察组;两组均严格实施营养管理及适当运动干预。通过随访调查比对两组不同妊娠时期血糖指标、不良妊娠结局及新生儿异常情况。结果观察组空腹及餐后2h血糖指标均低于对照组,差异有统计学意义(P<0.001);观察组自然分娩率(79.49%)高于对照组(48.72%),差异有统计学意义(χ^(2)=8.023,P=0.005);观察组不良妊娠率(5.13%)则低于对照组(20.51%),差异有统计学意义(χ^(2)=4.129,P=0.042),且观察组新生儿异常率(7.69%)低于对照组(28.21%),差异有统计学意义(χ^(2)=5.571,P=0.018)。结论对于妊娠期糖尿病孕妇实施筛查及早期干预措施意义关键。

Objective To investigate the impact of implementing gestational diabetes screening and early intervention on maternal and infant outcomes.Methods 78 pregnant women with gestational diabetes who underwent prenatal examination and gave birth in Yangzhou Jiangdu Maternal and Child Health Hospital from May 2019 to May 2022 were selected as research objects.All subjects were screened and diagnosed with gestational diabetes before 28 weeks of gestation,and were grouped according to the time of intervention for pregnant women,with 39 pregnant women with diabetes in late pregnancy(after 28 weeks)as the control group and 39 pregnant women with diabetes in the second pregnancy(24-28 weeks)as the observation group.Nutritional management and appropriate exercise intervention were strictly implemented in both groups.The glucose indexes,adverse pregnancy and outcome and neonatal abnormalities in the two groups were compared by follow-up survey at different gestational periods.Results The fasting and 2 h postprandial glucose indexes in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.001);the spontaneous delivery rate in the observation group(79.49%)was higher than that in the control group(48.72%),and the difference was statistically significant(χ^(2)=8.023,P=0.005).The rate of adverse pregnancy in the observation group(5.13%)was lower than that in the control group(20.51%),and the difference was statistically significant(χ^(2)=4.129,P=0.042),and the rate of neonatal abnormalities in the observation group(7.69%)was lower than that in the control group(28.21%),and the difference was statistically significant(χ^(2)=5.571,P=0.018).Conclusion The implementation of screening and early intervention measures for pregnant women with gestational diabetes is crucial.