三级围生保健对妊娠期糖尿病孕妇血糖控制及妊娠结局的影响

Effect of Tertiary Perinatal Care on Blood Glucose Control and Pregnancy Outcome in Pregnant Women with Gestational Diabetes Mellitus

目的 探究三级围生保健对妊娠期糖尿病孕妇血糖控制及妊娠结局的影响。方法 选择2021年3月—2022年3月在厦门市海沧医院定期产检且确诊为妊娠期糖尿病的78例孕妇作为研究对象,采用随机数表法将其分为对照组和研究组,各39例。对照组予以常规孕期保健和营养指导,研究组在常规孕期保健基础上实施三级围生保健,比较两组空腹血糖、餐后2 h血糖、糖化血红蛋白、每周体质量增长值,并追踪记录孕妇妊娠结局、新生儿结局。结果 干预1个月后,两组的空腹血糖、餐后2 h血糖、糖化血红蛋白水平均较干预前有改善,且研究组明显优于对照组,差异有统计学意义(P<0.05)。干预后,研究组孕妇每周体质量增长值低于对照组,差异有统计学意义(P<0.05)。研究组剖宫产率及早产、羊水过多、胎膜早破、巨大儿、新生儿低血糖发生率均显著低于对照组,差异有统计学意义(P<0.05)。结论 在妊娠期糖尿病孕期保健中实施三级围生保健能够更好控制血糖水平和体质量,对于改善妊娠结局、促进胎儿健康也具有积极的意义。

Objective To explore the effect of tertiary perinatal care on blood glucose control and pregnancy outcome in pregnant women with gestational diabetes.Methods From March 2021 to March 2022,78 pregnant women who were diagnosed with gestational diabetes in Xiamen Haicang Hospital during regular prenatal examination were selected as the study subjects.They were randomly divided into the control group and the study group,with 39 cases in each group.The control group received routine prenatal care and nutritional guidance,while the research group implemented three-level perinatal care on the basis of routine prenatal care.Fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,and weekly body mass growth values were compared between the two groups,and pregnancy outcomes and neonatal outcomes were tracked and recorded.Results After one month of intervention,the fasting plasma glucose,2-hour postprandial blood glucose,and glycated hemoglobin levels of the two groups improved compared to before intervention,and the study group was significantly better than the control group,the difference was statistically significant(P<0.05).After intervention,the weekly body mass growth value of pregnant women in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).The cesarean section rate and incidence of premature birth,polyhydramnios,premature rupture of membranes,macrosomia,and neonatal hypoglycemia in the study group were significantly lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion The implementation of tertiary perinatal health care in pregnancy care of gestational diabetes can better control blood glucose level and weight,which has positive significance for improving pregnancy outcome and promoting fetal health.