摘要
目的评价健康孕妇孕期糖化血红蛋白(glycosylated hemoglobin,HbAlc)水平对妊娠结局和新生儿的影响。方法收集2018-01-01-2018-12-31在无锡市第九人民医院进行定期产检的健康孕妇作为研究对象。根据孕30~32、36~38周时HbAlc值,将2次HbAlc值均>5.5%的35例孕妇纳入病例组,2次HbAlc值均<5.5%的40例孕妇纳入对照组,比较病例组和对照组各种妊娠结局和新生儿并发症发生率。结果75例孕妇均可排除妊娠期糖尿病诊断。两组孕妇孕30~32周HbAlc值分别为(5.65±0.54)%和(5.26±0.69)%,t=2.31,P<0.05;孕36~38周分别为(5.72±0.83)%和(5.18±1.01)%,t=2.79,P<0.05。病例组孕妇贫血22例,高于对照组的15例,χ~2=4.80,P<0.05;羊水过多6例,高于对照组1例,χ~2=4.73,P<0.05;子痫前期6例,高于对照组1例,χ~2=4.73,P<0.05;剖宫产22例,高于对照组8例,χ~2=14.29,P<0.01。病例组孕妇胎膜早破、羊水污染和肩难产发生率高于对照组,但差异无统计学意义,均P>0.05。病例组新生儿平均体质量为(3835.25±324.17)g,高于对照组(3201.18±189.23)g,t=4.92,P<0.05;巨大儿8例,对照组0例,χ~2=10.23,P<0.01;出生后1min Apgar评分≤7分7例,高于对照组的2例,χ~2=3.98,P<0.05;新生儿高胆红素血症6例,高于对照组1例,χ~2=4.73,P<0.05结局。结论健康孕妇孕期较高HbAlc水平可能导致不良妊娠结局,并对新生儿健康产生不良影响。
OBJECTIVE To examine the impact of glycosylated hemoglobin(HbA1c)levels during pregnancy on the pregnant outcomes and neonatal in healthy pregnant women.METHODS The healthy pregnant women receiving periodical pregnancy check-ups in Wuxi No.9 People’s Hospital from January through December 2018 were recruited.Based on the HbA1c values detected at gestational ages of 30 to 32 weeks and 36 to 38 weeks,35 pregnant women with both HbA1c values of>5.5%were enrolled in the observation group,and the 40 pregnant women with both HbA1c values of<5.5%were assigned into the control group.The incidence of pregnant and neonatal outcomes was compared between the two groups.RESULTS The diagnosis of gestational diabetes could be excluded in 75 pregnant women.At 30-32 weeks of gestation,HbAlc values of the two groups were(5.65±0.54)%and(5.26±0.69)%respectively,t=2.31,P<0.05.At 36-38 weeks of gestation,HbAlc were(5.72±0.83)%and(5.18±1.01)%,respectively,t=2.79,P<0.05.In the observation group,22 pregnant women had anemia,which was higher than 15 cases in the control group,χ~2=4.80,P<0.05;6 cases had excessive amniotic fluid in observation group,which was higher than 1 case in the control group,χ~2=4.73,P<0.05;6 cases had preeclampsia in observation group,which was higher than 1 case in the control group,χ~2=4.73,P<0.05;22 cases had cesarean section in observation group,which was higher than 8 cases in the control group,χ~2=14.29,P<0.01.The incidence of PROM,amniotic fluid pollution and shoulder dystocia in the observation group was higher than that in the control group,but the difference was not statistically significant(P>0.05).The average body mass of the newborn in the observation group was(3835.25±324.17)g,higher than that in the control group(3201.18±189.23)g,t=4.92,P<0.05;8 giant infants in the observation group,0 in the control group,χ~2=10.23,P<0.01;7 cases with Apgar score≤7 at one minute after birth in the observation group,higher than that in the control group,χ~2=3.98,P<0.05;6 cases with hyperbilirubinemia in the observation group,higher than that in the control group,1 case,χ~2=4.73,P<0.05.CONCLUSION High HbA1c level during pregnancy is associated with the pregnant outcomes and neonatal complications in healthy pregnant women,and a high HbA1c level many results in poor pregnant and neonatal outcomes.
作者
周佼佼
樊云
钦亚萍
ZHOU Jiao-jiao;FAN Yun;QIN Ya-ping(Department of Gynecology and Obstetrics,Wuxi No.9 People's Hospital,Wuxi 214062,P.R.China)
出处
《社区医学杂志》
2019年第24期1586-1589,共4页
Journal Of Community Medicine
关键词
糖化血红蛋白
妊娠
妊娠结局
新生儿
glycosylated hemoglobin
pregnancy
pregnant outcome
neonatal outcome
