摘要
目的探讨妊娠期糖尿病（GDM）早期筛查与治疗对妊娠结局的影响。方法选择2013年1月至2013年12月在湖北省天门市第一人民医院产前检查及分娩的115例GDM产妇作为研究对象,将其中于早孕期常规GDM筛查确诊为GDM,并接受规范性综合治疗的81例受试者纳入观察组,其余于中、晚孕期确诊为GDM的34例产妇纳入观察组-1,同时选择同期在相同医院接受产前检查并分娩的血糖正常产妇100例为对照组。对3组受试者的分娩方式、妊娠期并发症发生率及围生儿并发症发生率进行统计学分析。本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,征得受试对象的知情同意,并与之签署知情同意书。3组受试者年龄、产次、身高及体质量等一般临床资料比较,差异无统计学意义（P〉0.05）。结果 1本组确诊为GDM的115例患者中,于早孕期（孕龄为24-28孕周）接受产前GDM筛查并确诊为GDM的检出率为70.4%（81/115）。于中、晚孕期确诊为GDM的检出率为29.6%（34/115）。2观察组剖宫产率显著低于观察组-1,差异有统计学意义（P〈0.05）;而观察组与对照组上述并发症发生率比较,却差异无统计学意义（P〉0.05）。3观察组妊娠期高血压疾病、羊水过多、胎膜早破、早产及产后出血等妊娠并发症发生率,均显著低于观察组-1,差异均有统计学意义（P〈0.05）。与对照组比较,差异均无统计学意义（P〉0.05）。4观察组围生儿中,低出生体质量儿、巨大儿、胎儿窘迫、新生儿窒息、高胆红素血症及新生儿低血糖等并发症发生率,均显著低于观察组-1,差异均有统计学意义（P〈0.05）;而观察组与对照组比较,差异均无统计学意义（P〉0.05）。结论 GDM在早孕期被筛查,并采取及时有效的综合干预治疗措施,可降低妊娠并发症及围生儿并发症的发生率,对受试者妊娠结局具有较大影响。
Objective To explore effect of early screening and intervention treatment of gestational diabetes mellitus （GDM） on pregnancy outcome. Methods From January to December 2013,a total of 115 cases of pregnant women with GDM in Tianmen First People＇s Hospital were enrolled into this study. Among them who were diagnosed as GDM in early trimester of pregnancy by routine GDM screening were included into observation group （n：81）, the others who were diagnosed as GDM in mid and late trimester of pregnancy by GDM screening were included into observation group-1 （n = 34）. A total of 100 cases puerperants who delivered at the same period in the same hospital and with normal fasting blood sugar levels were included into control group. Statistical analysis was used to analyze the modes of delivery, incidence of pregnancy complications, and rates of perinatal infant complication among three groups. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Tianmen First People＇s Hospital.. Informed consent was obtained from all participants. There were no significant differences among three groups in age, parity, body height and body weight （P〉0. 05）. Results ① The rate of diagnosis as GDMin early trimester of pregnancy （from 24 to 28 gestational weeks） by routine GDM screening was 70.4% （81/115）. The rate of diagnosis as GDM in mid and late trimester of pregnancy by GDM screening was 29.6% （34/115）. ②The rate of cesarean section in observation group was much lower than that in observation group-l, and there were significant differences （P〈 0. 05）; but there were no significant differences between observation group and control group （P = 0. 08）.③ The incidences of pregnancy complications, such as hypertensive disorder complicating pregnancy, polyhydramnios,premature rupture of membrane, premature delivery and postpartum hemorrhage in observation group were much lower than those in observation group-l, and there were signifieant differences （P 〈 0. 05 ）; but there were no significant differences between observation group and control group （P〉0.05）. ④ The rate of perinatal infant complications, such as low birth weight infants, macrosomia infants, fetal distress, neonatal asphyxia, hyperbilirubinemia and neonatal hypoglycemia in observation group were much lower than those in observation group-l, and there were significant differences （P 〈 0. 05）, but there were no significant difference between observation group and control group （P〉0. 05） . Coneluslons Diagnosis as GDM in early trimester of pregnancy by routine GDM screening, and taking timely and effective treatment can reduce the incidences of pregnant complications, rate of perinatal infant complications, and improve pregnancy outcomes of GDM patients.
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2015年第2期46-49,共4页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
湖北省科技厅科技支撑项目(hb2012D166001639)~~
关键词
糖尿病
妊娠
孕期筛查
药物治疗
热量限制
妊娠并发症
妊娠结局
Diabetes gestational
Prenatal screening
Drug therapy
Caloric restriction
Pregnancy complications
Pregnancy outcome
