妊娠期糖尿病患者发生巨大儿的相关因素分析

Influence of associated risk factors of gestational diabetes mellitus and macrosomia

目的 :探讨妊娠期糖尿病 (GDM )患者发生巨大儿的相关因素。方法 :将 16 9例GDM患者分为 2组 ,巨大儿组 (新生儿出生体重≥ 4 0 0 0 g) 4 2例 ,非巨大儿组 (新生儿出生体重 2 5 0 0～ 3999g) 12 7例。对两组孕妇的一般情况及相关因素 (包括血糖水平、血糖控制孕周、控制方案等 )进行回顾性分析。结果 :巨大儿组孕末期糖化血红蛋白 (HbA1C)显著高于非巨大儿组 (P <0 .0 5 ) ;两组的产次及巨大儿史均存在统计学差异 (P <0 .0 5 ) ;巨大儿组中未进行治疗者、行单纯饮食治疗者及血糖控制不满意者均显著高于对照组 (均P <0 .0 1)。结论 :GDM患者的巨大儿发生与产次、巨大儿史和孕期血糖控制水平相关。对于GDM患者应及早诊断、及早处理 ,适当加用胰岛素治疗有助于降低巨大儿的发生率。

Objective:To explore the influence of associated risk factors of gestational diabetes mellitus(GDM) and macrosomia.Methods:42 newborns which birth weight over 4000 g as macrosomia and 127 newborns which birth weight 2500g 3999g as control group. This was a retrospective study of two group.Results:① The number of given childbirth in the group of macrosomia mother was higher than that in the control ( P <0.01),and the number of having previous fetal macrosomia were higher than that in the control( P <0.05) ②HbA 1C during late pregnancy in macrosomia group was higher than the control( P <0.05). ③Level of blood sugar in untreated people was significantly higher than that of the control( P <0.01).Level of blood sugar of the macrosomia mother group by diet control and other therapy control is still higher than that of control group( P <0.01).Conclusion:Macrosomia is related with history of childbirth , previous fetal macrosomia and glucose level being controlled during pregnancy.The early diagnosis and treatment and make use of insulin play a role in decreasing GDM and macrosomia.