妊娠期糖尿病预后与脑-胎盘率的相关性研究

Relationship between prognosis of gestational diabetes mellitus and cerebro-placental ratio

目的探讨胎儿脑-胎盘率(CPR)与妊娠期糖尿病(GDM)妊娠结局的关系。方法回顾性分析2013年1月至2017年5月在温州医科大学附属第二医院就诊的80例GDM孕妇,分析其临床资料和GDM组妊娠结局,通过ROC曲线判断胎儿CPR在GDM孕妇不良妊娠结局中的诊断临界值,利用Logistic回归分析得出影响GDM孕妇不良妊娠结局的危险因素。结果正常妊娠组与不良妊娠组在孕期体重增加重量、妊娠高血压比例、分娩方式及CPR值方面差异均有统计学意义(t/χ~2值分别为7.297、8.910、12.830、13.726,均P<0.05);CPR对不良妊娠结局的诊断折点为0.92(Z=6.806,P<0.05)。Logistic回归分析结果显示妊娠期高血压、剖宫产、CPR<0.92是GDM孕妇不良妊娠结局的危险因素(OR值分别为1.47、1.83、2.65,均P<0.05)。结论对于GDM患者,检测胎儿CPR可有效预测不良妊娠结局,对改善GDM孕妇预后具有一定的参考价值。

Objective To investigate the relationship between fetal cerebro-placental ratio(CPR)and pregnancy outcomes of gestational diabetes mellitus(GDM).Methods Retrospective analysis was conducted on the clinical data and pregnancy outcomes of80 women with GDM who treated in the 2 nd Affiliated Hospital of WMU during the period of January 2013 to May 2017.The critical value of fetal CPR in the diagnosis of adverse pregnancy outcomes in GDM women was determined by ROC curve.Logistic regression analysis was used to identify the risk factors of adverse pregnancy outcomes.Results The differences were statistically significant in gestational weight gain,proportion of gestational hypertension,delivery mode and CPR between normal pregnant group and adverse pregnant group(t/χ~2 value was 7.297,8.910,12.830 and 13.726,respectively,all P <0.05).The CPR diagnosis value for adverse pregnancy outcome was 0.92(Z =6.806,P =0.003).Logistic regression analysis showed that gestational hypertension,cesarean and CPR<0.92 were risk factors for adverse pregnancy outcomes in GDM women(OR value was 1.47,1.83 and 2.65,respectively,all P<0.05).Conclusion Detection of fetal CPR in GDM patients can effectively predict adverse pregnancy outcomes,which has a certain reference value for improving the prognosis of GDM women.