不同年龄段孕中期孕妇糖耐量血糖特征及其对胎儿心功能的影响

Characteristics of glucose tolerance and blood glucose of pregnant women of different ages in the second trimester of pregnancyand its influence on fetal heart function

目的 分析不同年龄段孕中期孕妇糖耐量血糖特征及其对胎儿心功能的影响。方法 选取2020年4月至2022年4月于南昌市第三医院行产检的1200例孕妇为研究对象,依据其年龄分为5组:20~25岁为A组(n=389),25~30岁为B组(n=305),30~35岁为C组(n=218),35~40岁为D组(n=136),40~45岁为E组(n=152),对所有孕妇行口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)与超声检查,分析对比5组间的糖耐量血糖特征与各组胎儿心功能的差异。结果 E组与D组的空腹血糖(fasting blood glucose,FBG)、1hFBG、2hFBG高于A、B、C组,且E组高于D组;E组与D组的OGTT阳性率高于A、B、C组,且E组高于D组;E组与D组的FBG与1h、2h的FBG异常率高于A、B、C组;E组与D组的左心室壁厚度(left ventricular wall thickness,LVWT)、右心室壁厚度(right ventricular wall thickness,RVWT)、舒张期室间隔厚度(interventricular septum thickness in diastole,IVSd)、左心室射血分数(left ventricular ejection fraction,LVEF)高于A、B、C组,且E组高于D组,差异均有统计学意义(P<0.05);而A、B、C组LVWT、RVWT、IVSd、LVEF相比,差异均无统计学意义(P>0.05)。结论 孕中期孕妇随着年龄的增加,其糖耐量异常检出率不断增高,而年龄越大,孕妇机体血糖异常率越高,对胎儿心功能的影响也越大。因此,需加强高龄孕妇的OGTT的筛查,以尽可能减少妊娠期糖尿病的发生,改善妊娠结局。

Objective To analyze the characteristics of glucose tolerance and blood glucose of pregnant women of different ages in the second trimester of pregnancy and their effects on fetal cardiac function in Nanchang.Methods A total of 1200 pregnant women in Nanchang Third Hospital from April 2020 to April 2022 were selected and divided into 5 groups according to their age:20-25 years old as group A(389 cases),25-30 years old as group B(305 cases),30-35 years old as group C(218 cases),35-40 years old as group D(136 cases),and 40-45 years old as group E(152 cases).All pregnant women were subjected to oral glucose tolerance test(OGTT) and ultrasound examination,the characteristics of glucose tolerance and blood glucose and the differences of fetal heart function among the five groups were analyzed and compared.Results The fasting blood glucose(FBG),1hFBG,and 2hFBG levels in group E and group D were higher than those in groups A,B and C,and group E was higher than those in group D.The positive rates of OGTT in groups E and D were higher than those in groups A,B,and C,and group E was higher than group D.The abnormal rates of FBG and 1h and 2hFBG in groups E and D were higher than those in groups A,B,and C;the left ventricular wall thickness(LVWT),right ventricular wall thickness(RVWT),Interventricular septum thickness in diastole(IVSd) and left ventricular ejection fraction(LVEF) of group E and group D were higher than those of group A,B and C,and group E was higher than that in group D,the differences were statistically significant(P<0.05);there were no significant difference in LVWT,RVWT,IVSd and LVEF among group A,B and C(P<0.05).Conclusion With the increase of age,the detection rate of abnormal glucose tolerance of pregnant women in the second trimester of pregnancy is increasing continuously.The older pregnant women was,the higher the abnormal rate of maternal blood glucose was,and the greater the impact on fetal heart function was.Therefore,it is necessary to strengthen the screening of OGTT for older pregnant women to reduce the occurrence of gestational diabetes mellitus and improve the pregnancy outcome.