摘要
目的:探讨妊娠期糖尿病孕妇不同血糖控制状况的围产结局。方法:选取2020年6月至12月定期产前检查的孕妇1 036例为研究对象,根据口服糖耐量试验(OGTT)结果分为正常糖耐量(NGT)孕妇436例(NGT组)和妊娠期糖尿病(GDM)孕妇600例,GDM孕妇根据其孕期血糖控制状况分为控制不良组(n=112)和控制良好组(n=488)。比较3组孕妇分娩前空腹血糖和糖化血红蛋白(HbA1c)水平、妊娠期和围产儿并发症发生情况。采用Logistic回归分析血糖控制状况与围产结局的关系。结果:3组孕妇分娩前空腹血糖和HbA1c水平、妊娠期和围产儿并发症发生情况比较,差异有统计学意义(P<0.05),控制不良组孕妇分娩前空腹血糖和HbA1c水平、妊娠期和围产儿并发症的发生率最高(P<0.05)。血糖控制不良组子痫前期、胎膜早破、产后出血,早产儿、巨大儿、新生儿低血糖、新生儿高胆红素血症、新生儿窒息和转儿科等的发生风险较大[OR(95%CI)分别为4.222(1.789~9.960)、5.394(2.816~10.329)、4.890(2.003~11.939)、4.150(1.755~9.816)、8.259(3.970~17.182)、4.936(2.291~10.634)、5.197(2.316~11.661)、4.459(1.860~10.688)、3.845(2.000~7.392)];血糖控制良好组胎膜早破、巨大儿、转儿科的发生风险较大[OR(95%CI)分别为2.524(1.548~4.116)、2.327(1.274~4.252)、1.865(1.099~3.165)]。结论:GDM孕妇血糖控制不良可增加母婴不良围产结局的发生风险,血糖控制水平越差,母婴不良围产结局的发生率越高。
Aim:To investigate the perinatal outcomes of pregnant women with gestational diabetes mellitus(GDM) and different blood glucose control level.Methods:A total of 1 036 pregnant women were allocated into normal glucose tolerance group(n=436)and GDM group(n=600)according to the results of oral glucose tolerance test(OGTT).Then,pregnant women with GDM were divided into poor-controlled group(n=112) and well-controlled group(n=488) according to blood glucose control level.To compare the blood glucose level before delivery,glycohemoglobin,the pregnancy complications and perinatal infants complications,and analyze the relationship between blood glucose control level and perinatal outcomes by logistic regression analysis.Results:The blood glucose level before delivery,glycohemoglobin,the pregnancy complications and perinatal infants complications among the 3 groups were statistically different(P<0.05).The incidence of pregnancy complications and adverse perinatal outcomes in the poor-controlled group was the highest(P<0.05).The results of Logistic regression analysis showed that pregnant women in poor-controlled group had higher risks of preeclampsia,premature rupture of membranes,postpartum hemorrhage,premature infants,macrosomia,neonatal hypoglycemia,neonatal hyperbilirubinemia,neonatal asphyxia being and transferred to pediatrics[OR(95%CI) were 4.222(1.789-9.960),5.394(2.816-10.329),4.890(2.003-11.939),4.150(1.755-9.816),8.259(3.970-17.182),4.936(2.291-10.634),5.197(2.316-11.661),4.459(1.860-10.688),3.845(2.000-7.392)].The risks of premature rupture of membranes,macrosomia and being transferred to pediatrics were increased in well-controlled group[OR(95%CI) were 2.524(1.548-4.116),2.327(1.274-4.252),1.865(1.099-3.165)].Conclusion:The risk of adverse perinatal outcomes in pregnant women with blood glucose poor-controlled GDM is increased.The worse the blood glucose control level of pregnant women with GDM,the higher the incidence of adverse perinatal outcomes.
作者
韩宁
赵红阳
徐冬梅
魏团君
陈莹莹
常鑫媛
HAN Ning;ZHAO Hongyang;XU Dongmei;WEI Tuanjun;CHEN Yingying;CHANG Xinyuan(Department of Obstetrics and Gynecology,the Third Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2022年第3期387-391,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
河南省教育厅重点科研项目(20A320041)。
关键词
妊娠期糖尿病
血糖控制状况
围产结局
gestational diabetes mellitus
blood glucose control level
perinatal outcome
