单纯葡萄糖筛查试验异常对妊娠结局和新生儿体质指标的影响  

Pregnant outcomes and neonatal anthropometry in women with abnormal glucose challenge test and normal oral glucose tolerance test during pregnancy

作　　者：陈海天[1] 王子莲[1] 胡明晶[1] 李铭岚[1] 祝文晶[1] 刘斌[1] 

机构地区：[1]中山大学附属第一医院妇产科,广州510080

出　　处：《中华妇产科杂志》2009年第11期801-804,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的探讨妊娠期单纯葡萄糖筛查试验（GCT）异常对妊娠结局和新生儿体质指标的影响。方法收集2006年11月至2007年12月于中山大学附属第一医院妇产科住院分娩的孕妇214例，于孕24—28周时行50gGCT，若服糖后1h血糖／〉7．8mmol／L，再行75g口服葡萄糖耐量试验（OGTT），空腹血糖及服糖后1h、2h、3h血糖标准分别为5．3mmol／L、10．0mmol／L、8．6mmol／L和7．8mmol／L，4项血糖值均未达到上述标准，为OGTF正常。50gGCT异常、但75gOGTT正常的116例孕妇及其新生儿为单纯GCT异常组；50gGCT正常的98例孕妇及其新生儿为GCT正常组。对两组母儿结局进行分析。记录两组新生儿的出生体重、身长、头围、肩周围值；于出生后24h内以皮尺测定其上臂围，以直尺测定其肱三头肌皮褶厚度及腹壁皮下脂肪厚度。结果（1）两组母儿结局：单纯GCT异常组孕妇的阴道助产率[10．3％（12／116）]、羊水过多发生率[5．2％（6／116）]、胎膜早破发生率[13．8％（16／116）]、胎儿窘迫发生率[20．7％（24／116）]与GCT正常组[分别为4．1％（4／98）、10．2％（10／98）、17．3％（17／98）、13．3％（13／98）]比较，差异均无统计学意义（P〉0．05）；单纯GCT异常组孕妇的剖宫产率[72．4％（84／116）]、阴道顺产率[17．2％（20／116）]、大于胎龄儿出生率[25．9％（30／116）]，与GCT正常组[分别为51．O％（50／98）、44．9％（44／98）、6．1％（6／98）]比较，差异均有统计学意义（P〈0．05）。（2）新生儿体质指标：单纯GCT异常组新生儿出生体重为（3．4±0．4）kg，与GCT正常组的（3．3±0．4）k比较，差异有统计学意义（P〈0．05）；单纯CCT异常组新生儿身长[（49．9±1．3）cm]、头围[（33．4±1．5）cm]、肩周围[（35．4±2．3）cm]、上臂围[（11．0±0．7）cm]、肱三头肌皮褶厚度[（9．7±1．0）mm]、腹壁皮下脂肪厚Objective To evaluate the influences of abnormal glucose challenge test （GCT） on pregnancy outcomes and neonatal anthropometric data in women with normal oral glucose tolerance test （OG3T）. Methods Totally 214 women who delivered in the First Affiliated Hospital of Sun Yat-sen University from November 2006 to December 2007 were enrolled. 50 g GCT was performed at 24-28 weeks of gestation and 75 g OGTT would be followed if GCT ≥ 7.8 mmol/L Those patients, whose OGTF results below the following criteria （5.3 mmol/L,10.0 mmol/L,8.6 mmol/L,7.8 mmol/L） , were classified as normal OGTT. Altogether, 116 of the 214 women with abnormal GCT and normal OGTT were collected as the study group and the rest 98 women with normal GCT as the control group. The pregnant outcomes of the two groups were analyzed. The neonatal anthropometry, including birth weight, body length, head circumference and shoulder circumference, were recorded. Other neonatal anthropometric data, such as upper arm circumference, tricep skinfold thickness and hypodermic fat thickness of abdomen were measured by a tape measure within 24 hours after birth. Results （ 1 ） Pregnant outcomes ： No significant difference was found in the rate of assisted vaginal delivery, polyhydramnios, premature rupture of membranes and fetal distress between the study and control group[ 10. 3% （12/116） vs 4% （4/98）, 5.2% （6/116） vs 10% （10/98）, 13.8% （16/116） vs 17% （17/98）, 20.7% （24/116） vs 13% （13/98）, P 〉 0.05, respectively] , but the rate of cesarean section, spontaneous vaginal delivery and large for gestational age babies in the study group were different from those of the control [72.4% （84/116） vs 51% （51/98）, 17.2%（20/116） vs 45%（44/98）, 25.9% （50/116） vs6%（6/98）, P〈0.05, respectively]. （2） Neonatal anthropometry ： The birth weight of the study group was significantly higher than that of the control group [ （ 3.4 ± 0. 4） kg vs （ 3.3 ± 0. 4） kg, P 〈 0. 05 ], but no significa

关 键 词：血糖 葡糖耐量试验 妊娠并发症 高血糖症 妊娠结局 体重与身体测量 婴儿 新生 

分 类 号：R686[医药卫生—骨科学]