妊娠期糖尿病患者分娩前血糖控制水平与剖宫产术后新生儿血糖水平的相关性分析

Correlation Analysis between Blood Glucose Control Level before Delivery and Blood Glucose Level of Newborns after Cesarean Section in Pregnant Women with Diabetes

【目的】探讨妊娠期糖尿病(GDM)患者分娩前血糖控制水平与剖宫产术后新生儿血糖水平的相关性。【方法】选取2017年4月至2020年4月在延安大学附属医院行剖宫产分娩的162例GDM患者,所有患者分娩前均行常规的血糖控制(饮食控制、运动指导),依据分娩前1 d血糖监测结果分为A组[2次空腹血糖(FPG)>6.16 mmol/L,n=72]与B组(2次FPG≤6.16 mmol/L,n=90)。两组产妇均在常规血糖控制后分娩前行FPG、餐后2h血糖(2hPG)及糖耐量试验(OGTT)检测,两组新生儿均在出生后6 h、12 h、24 h检测FPG、2hPG。统计两组患者妊娠结局,通过Spearman系数分析两组患者血糖指标与新生儿出生后血糖指标的相关性。【结果】A组FPG、2hPG、OGTT水平显著高于B组,差异有统计学意义(P<0.05);A组新生儿出生后6 h、12 h、24 h血清FPG、2hPG水平显著低于B组,差异有统计学意义(P<0.05)。A组产妇产后出血、早产、巨大儿、低血糖、羊水过多发生率显著高于B组,差异有统计学意义(P<0.05);A组新生儿Apgar评分显著低于B组,差异有统计学意义(P<0.05)。相关性分析显示:A组患者FPG、2hPG水平与新生儿24 h时FPG、2hPG呈负相关(P<0.05)。【结论】GDM患者血糖水平高可引发一系列的母婴并发症,危及母婴健康,同时相关性分析证实GDM患者血糖水平与新生儿血糖水平密切相关。

【Objective】To explore the correlation between the blood glucose control level before delivery and the blood glucose level of newborns after cesarean section in patients with gestational diabetes mellitus(GDM).【Methods】A total of 162 GDM patients who underwent cesarean section in the Affiliated Hospital of Yan'an University from April 2017 to April 2020 were selected.All patients underwent routine blood glucose control(diet control,exercise guidance)before delivery.According to the blood glucose monitoring results one day before delivery,they were divided into group A(twice FPG>6.16 mmol/L,n=72)and group B(twice FPG≤6.16 mmol/L,n=90).FPG,2hPG and OGTT were measured before delivery after routine blood glucose control.FPG and 2hPG were detected at 6 h,12 h and 24 h after birth in both groups.The pregnancy outcome of the two groups of patients was counted,and the correlation between the blood glucose index of the two groups of patients and the blood glucose index of the newborn after birth was analyzed by Spearman coefficient.【Results】The levels of FPG,2hPG and OGTT in the group A were significantly higher than those in the group B,and the difference was statistically significant(P<0.05);The serum FPG and 2hPG levels of newborns in the group A were significantly lower than those in the group B at 6 h,12 h and 24 h after birth(P<0.05).The incidence of postpartum hemorrhage,premature delivery,macrosomia,hypoglycemia and polyhydramnios in the group A was significantly higher than that in the group B,and the difference was statistically significant(P<0.05);The Apgar score of newborns in the group A was significantly lower than that in the group B(P<0.05).The correlation analysis showed that the FPG and 2hPG levels in the group A were negatively correlated with the blood glucose levels of FPG and 2hPG at 24 h of newborn(P<0.05).【Conclusion】The high blood glucose level of GDM patients can cause a series of maternal and infant complications and endanger the health of mothers and infants.At the same time,the correlation analysis confirms that the blood glucose level of GDM patients is closely related to the blood glucose level of newborns.