摘要
目的:探讨双胎妊娠合并妊娠期糖尿病(GDM)孕妇临床特征及对新生儿早期不良结局的影响.方法:收集2017年1月-2022年1月于本院住院的719例单双胎GDM者母婴临床资料,同期正常双胎妊娠者母婴临床资料作为对照组,并行多因素logistic回归分析探讨GDM母婴早期不良结局的影响因素.结果:GDM产妇相较于单胎,双胎妊娠产妇胰岛素使用频率更低(P<0.05),妊娠晚期糖化血红蛋白水平及子痫前期发病率更高(P<0.05);双胎妊娠新生儿更易患新生儿疾病及胎龄更小(P<0.05),更易发生小于胎龄儿(SGA)、早产、高胆红素血症和气胸等早期不良结局(P<0.05).与正常双胎妊娠产妇相比,GDM双胎妊娠产妇体质指数(BMI)、孕期体重增长更低且更易剖宫产(P<0.05),但两组产妇早期不良结局无统计学差异(P>0.05).与正常双胎妊娠新生儿相比,GDM双胎妊娠新生儿SGA、大于胎龄儿(LGA)发生率更低(P<0.05),早期不良结局无统计学差异(P>0.05).多因素logistic显示,SGA(OR=7.357,95%CI2.136~25.341)、早产(OR=5.329,95%CI1.430~19.852)和应用辅助生殖技术(OR=6.838,95%CI1.715~27.263)为GDM双胎新生儿早期不良结局的危险因素.结论:GDM双胎妊娠中,早期积极预防与治疗SGA及早产,定期进行孕前检查及更优质辅助生殖技术均可有效降低新生儿早期不良结局的发生.
Objective:To explore the maternal and nconatal clinical characteristics of twin pregnant women with gestational diabetes mellitus(GDM),and to study its influence on the neonatal early adverse outcomes.Methods:The maternal and nconatal clinical data of 719 twin pregnant women with GDM(in study group)from January 2017 to January 2022 were ollcted.The pregnant women with normal twin pregnancies during the same period were included in control group.The influence factors of the maternal and neonatal early adverse outcomes of the women with GDM were investigated by multivariate logistic regression analysis.Results:Among the pregnant women with GDM,the frequency of insulin used of the women with twin pregnancies was significantly lower than that of the women with singleton pregnancy(P<0.05),and the glycosylated hemoglobin level and the incidence of preeclampsia of the women with twin pregnancies during the third trimester of pregnancy were significantly higher than those of the women with singleton prcgnancy(P<0.05).The nconatal diseases rate of the women with twin pregnancies was significantly higher than that of the women with singleton pregnancy,and the gestational weeks at delivery of the women with twin pregnancies was significantly less than that of the women with singleton pregnancy(P<0.05).The rates of the neonatal early adverse outcomes,such as small for gestational age(SGA),preterm birth,hyperbilirubinemia,and pneumothorax,of the women with twin pregnancies were significantly higher than those of the women with singleton pregnancy(P<0.05).The body mass index(BMI)value and the weight gain during pregnancy of the women in the study group were significantly lower than those of the womcn in the control group,and the cesarcan section rate of the women in the study group was significantly higher(P<<0.05).There was no significant difference in the early adverse outcomes of the women between the two groups(P>0.05).The incidences of neonatal SGA and large for gestational age(LGA)in the study group were significantly lower than those in the control group(P<0.05),and there was no significant difference in the early neonatal adverse outcomes(P>0.05).Multivariate logistie regression analysis showed that the SGA(OR-7.357,95%CI 2.136-25.341).the preterm birth(OR=5.329,95%CI 1.430-19.852).and the assisted reproductive technology used(OR-6.838,95%CI 1.715-27.263)were the early risk factors of the neonatal adverse outcomes of the women with twins and GDM Conclusion:The early active prevention and treatment of SGA and preterm birth,and the regular prer pregnancy examination and better assisted reproductive technology of the pregnant women with twin pregnancies and GDM can efectively reduce the incidence of their neonatal early adverse outcomes.
作者
李红霞
朱凯
刘雯
夏金蓉
谢江
LI Hongxia;ZHU Kai;LIU Wen;XIA Jinrong;XIE Jiang(The Third People’s Hospital of Chengdu/The Second Affiliated Hospital of Chengdu,Chongqing Medical University,Chengdu,Sichuan Province,610031;School of Nursing,Xinjiang Medical University,Urumqi,Xinjiang Uygur Autonomous Region)
出处
《中国计划生育学杂志》
2024年第1期201-206,共6页
Chinese Journal of Family Planning
基金
四川省科技计划项目(2021YJ0170)。
关键词
妊娠期糖尿病
双胎妊娠
临床特征
不良妊娠结局
Gestational diabetes mellitus
T win pregnancies
Clinical characteristics
Adverse pregnancy outcomes
