妊娠期糖尿病孕妇早产与足月分娩临床特征差异性分析  

作　　者：庾艳华[1] 徐建中[1] 邓佩瑛[2] 吴瑜瑜[3] 黄启涛[3] 

机构地区：[1]南方医科大学附属花都区人民医院产科,510800 [2]南方医科大学南方医院重症医学科,510515 [3]南方医科大学南方医院产科,510515

出　　处：《当代医学》2012年第24期11-12,共2页Contemporary Medicine

摘　　要：目的探讨妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇早产及足月分娩的临床特征差异以及妊娠期糖尿病孕妇早产危险因素。方法选择2008年1月～2010年12月在南方医科大学附属花都区人民医院、南方医院住院并分娩的GDM孕产妇238例,其中发生早产65例(GDM早产组),足月分娩173例(GDM足月组),采用单因素及多因素回归方法分析GDM孕妇早产危险因素。结果 (1)单因素回归分析提示既往早产史、IVF-ET、双胎及多胎妊娠、年龄、体质指数、收缩压、糖化血红蛋白、24h尿蛋白定量、以及子痫前期、胎膜早破、胎盘早剥、胎儿窘迫等妊娠期并发症是GDM早产发生的危险因素(P<0.05);(2)多因素回归分析结果显示,既往早产病史(OR=2.318,95%CI为1.096～12.596,P=0.035)、子痫前期(OR=3.597,95%CI为2.308～19.167,P=0.000)、胎膜早破(OR=2.839,95%CI为1.254～6.692,P=0.000)是GDM孕妇早产发生的独立危险因素。结论 GDM早产组和GDM足月分娩组在临床特征和妊娠并发症发生率上存在一定差异性。既往早产病史、子痫前期、胎膜早破是GDM孕妇早产发生的独立危险因素。加强产前检查和孕期保健、积极筛查GDM、对GDM孕妇采取有效措施控制血糖、尽早发现相关妊娠期并发症是减少GDM早产的有效手段。Objective To investigate clinical features and the risk factors in gestational diabetes mellitus （GDM） with or without preterm delivery. Methods From January, 2008 to December, 2010, 238 GDM women were enrolled in this study, including 65 GDM women with preterm delivery and 173 GDM women without preterm delivery. Univariate and multivariate regression analysis were used to identify the risk factors for preterm delivery in patients with GDM.Results （1） Univariate analysis showed that previous preterm birth, IVF-ET, twin and multiple pregnancies, age, body mass indexl systolic blood pressure, glycosylated hemoglobin, 24h urinary protein as well as preeclampsia, premature rupture of membrane, placental abruption, fetal distress are risk factors for GDM women with preterm birth（P〈0.05）. （2）Logistic regression analysis showed that previous preterm birth （OR=2.318,95%CI 1.096- 12.596,P=-0.035）, preeclampsia （OR=3.597,95%CI 2.308- 19.167,P=0.000） and premature rupture of membrane （OR=2.839,95%CI 1.254-6.692,P=0.000） were independent risk factors with GDM women with preterm birth. Conclusion Previous preterm birth, preeclampsia and premature rupture of membrane were independent risk factors with GDM women with preterm birth. Improved the prenatal care and antenatal care and timely detection of pregnancy complications in GDM women were important measurements in decreasing the prevalence of preterm birth in GDM.

关 键 词：妊娠期糖尿病 早产 临床特征 

分 类 号：R714.2[医药卫生—妇产科学]