摘要
目的探讨高龄产妇合并妊娠期糖尿病对妊娠结局、并发症发生情况的影响及意义。方法将2013年6月至2018年6月于兰溪市妇幼保健计划生育服务中心产科诊断妊娠并住院分娩的妊娠期糖尿病高龄孕妇136例、妊娠期糖尿病适龄孕妇105例、妊娠期非糖尿病高龄孕妇123例、妊娠期非糖尿病适龄孕妇115例分别设为A、B、C、D四组,比较各组的临床资料,分析各组的妊娠结局、妊娠相关并发症及围产儿情况的差异。结果 A组剖宫产率明显高于B、C、D组(χ^2值分别为5.80、9.73、12.32,均P<0.05),A组分娩孕周小于B、C、D组(t值分别为7.86、8.00、9.17,均P<0.05);A组妊娠期高血压发生率明显高于B、C、D组(χ^2值分别为6.92、7.29、7.28,均P<0.05)。各组间子痫前期、胎膜早破、前置胎盘、羊水过多及产后出血发生率比较差异均无统计学意义(均P>0.05)。胎儿生长受限发生率:A组高于C组和D组,B组高于C组和D组;新生儿低血糖发生率:A组高于C组、D组,B组高于C组、D组;病理性黄疸发生率:A组高于D组,B组高于C组和D组;新生儿窒息发生率:A组高于D组,B组高于D组,以上比较差异均具有统计学意义(χ^2=4.35~6.91,均P<0.05)。四组间围生儿畸形、巨大儿、新生儿红细胞增多症及新生儿肺炎的发生率差异均无统计学意义(均P>0.05)。结论高龄妊娠和妊娠期糖尿病对母婴存在危害性影响,应提倡产前检查,并加强高龄妊娠围产期监护。
Objective To explore the influence and significance of maternal gestational diabetes mellitus on pregnancy outcomes and complications.Methods From June 2013 to June 2018, 136 advanced age pregnant women with gestational diabetes mellitus, 105 proper age pregnant women with gestational diabetes mellitus, 123 advanced age pregnant women without diabetes mellitus, and 115 proper age pregnant women without diabetes mellitus hospitalized in Lanxi Maternal and Child Health Care Family Planning Service Center were set to group A, group B, group C, and group D, respectively. The clinical data of each group were collected and analyzed, and the differences in pregnancy outcomes, pregnancy-related complications and perinatal conditions were analyzed. Results The cesarean section rate in group A was significantly higher than that in group B, group C and group D(χ^2 value was 5.80, 9.73 and 12.32, respectively, all P<0.05), while the gestational week in group A were less than that in group B, group C and group D(t value was 7.86, 8.00 and 9.17, respectively, all P<0.05). The incidence of pregnancy hypertension in group A was significantly higher than that in group B, group C and group D(χ^2 value was 6.92, 7.29 and 7.28,respectively, all P<0.05). There was no significant difference in the incidence of preeclampsia, premature rupture of membranes, placenta previa, polyhydramnios and postpartum hemorrhage among four groups(P>0.05). The incidence of fetal growth restriction in group A was higher than that in group C and group D(P<0.05), and that in group B was higher than that in group C and group D(P<0.05). The incidence of neonatal hypoglycemia in group A was higher than that in group C and group D(P<0.05), and that in group B was higher than that in group C and group D. The incidence of neonatal asphyxia in group A was higher than that in group D, and that in group B was higher than that in group C and group D. The incidence of neonatal asphyxia in group A and group B was higher than that in group D. The above differences were statistically significant(χ^2 value ranged 4.35-6.91, all P<0.05). There was no significant difference in the incidence of perinatal malformation, macrosomia, neonatal polycythemia and neonatal pneumonia among four groups(all P>0.05). Conclusion Advanced age pregnancy and maternal diabetes have harmful effect on mothers and infants. Prenatal examination should be promoted and the perinatal monitoring of advanced pregnancy should be strengthened.
作者
祝朝萍
刘沙
赵旭梦
ZHU Zhaoping;LIU Sha;ZHAO Xumeng(Department of Gynecology and Obstetrics, Lanxi Maternal and Child Health Care Family Planning Service Center, Zhejiang Lanxi 321100, China)
出处
《中国妇幼健康研究》
2019年第7期851-855,共5页
Chinese Journal of Woman and Child Health Research
基金
浙江省医药卫生适宜技术成果转化计划资助项目(2015ZHB007)
关键词
高龄孕妇
妊娠期糖尿病
妊娠结局
并发症
pregnant women of advanced age
gestational diabetes mellitus
pregnancy outcomes
complications
