血糖及体重控制对妊娠期糖尿病孕妇分娩结局影响

Effects of blood glucose and body mass control of women with gestational diabetes mellitus on their delivery outcomes

目的:探讨血糖及体重控制对GDM孕妇分娩结局的影响。方法:收集本院2021年1月-2023年1月诊治的GDM患者87例,根据是否接受血糖、体重控制分为未干预组(n=29)、血糖控制组(n=28)、血糖联合体重控制组(n=30),健康孕妇28例作为对照组。记录孕妇孕前、GDM确诊时、分娩前体格及分娩相关资料(分娩方式、围产期胎儿或新生儿)。结果:分娩前血糖控制组及血糖联合体重控制组体格及血糖水平均好于未干预组(P<0.05)。各种胎儿均正常活胎。未干预组分娩孕周少于对照组、剖宫产比例高于对照组,分娩孕期血糖控制组(289.5±27.4d)、血糖联合体重控制组(284.2±25.1d)高于未干预组(261.52±4.4d),剖宫产比例(42.9%、13.3%)低于未干预组(58.6%)(均P<0.05)。各组产前胎儿双顶径、胎儿股骨长无差异(P>0.05),血糖控制组及血糖联合体重控制组胎儿腹围高于未干预组,羊水指数和S/D小于未干预组(P<0.05)。产前胎盘异常、脐带异常各组无差异(P>0.05),羊水异常发生率血糖控制组(53.6%)、血糖联合体重控制组(33.3%)低于未干预组(69.0%)(P<0.05)。新生儿1~10 min Apgar评分和新生儿体重血糖控制组(3.7±0.6 kg)、血糖联合体重控制组(3.6±0.6 kg)均高于未干预组(3.2±0.4 kg)(P<0.05)。结论:血糖联合体重控制更有助于改善GDM孕妇的妊娠结局。

Objective:To investigate the effects of blood glucose and body mass control of pregnant women with gestational diabetes mellitus(GDM)on their delivery outcomes.Methods:87pregnant women with GDM were collected in study group,and were divided into 29women without intervention in group A,28women with blood glucose control in group B,and 30women with blood glucose and body mass control in group C according to different intervention methods from January 2021to January 2023.28healthy pregnant women were selected in control group during the same period.The data related to delivery,such as delivery mode and the situation of perinatal fetus or newborn,of the women before pregnancy,at the time of GDM diagnosis,and before delivery were recorded.Results:The physical condition and the blood glucose level of the women in group B and in group C were all significantly better than those of the women in group A(P<0.05).All the fetuses in the three groups were normal live birth.The gestational weeks of the women in group A at delivery was significantly lower than that of the women in group C,and the proportion of caesarean section of the women in group A was significantly higher than that of the women in the control group.The gestational weeks of the women at childbirth in group B or in group C was significantly higher than that53 of the women in group A.The proportion of caesarean section of the women in group B(42.9%)and in group C(13.3%)was significantly lower than that(58.6%)of the women in group A(all P<0.05).The prenatal fetal double parietal diameter and the fetal femur length were not significant differences among the three groups(P>0.05).The values of the fetal abdominal circumference in group B and in group C was significantly higher than that in group A,and the values of amniotic fluid index and the S/D of the women in group B and in group C were significantly lower than those of the women in group A(P<0.05).There were no significant differences in the incidences of prenatal placental abnormality and umbilical cord abnormality of the women among the three groups(P>0.05).The incidence of abnormal amniotic fluid of the women in group B(53.6%)or in group C(33.3%)was significantly lower than that(69.0%)of the women in group A(P 0.05).The neonatal Apgar score and neonatal weight in group B and in group C were significantly higher than those in group A(P<0.05).Conclusion:The combined controls of blood glucose level and body mass of the pregnant women with GDM is helpful to improve their pregnancy outcomes.