两种妊娠糖尿病筛查方法与妊娠结局的关系分析  

Correlation between two methods of GDM screening with pregnancy outcomes

作　　者：吴芬英[1] 李媛[1] 孟杨南 田徐琴 李莎[1] 

机构地区：[1]中国医科大学绍兴医院产科,浙江绍兴312000

出　　处：《中国妇幼健康研究》2014年第2期244-246,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨孕妇在不同妊娠期糖尿病筛查方法及妊娠结局。方法对600例孕妇分组进行教科书建议的50 g糖筛查试验(GST)和采用国际妊娠与糖尿病研究组织(IADPSG)诊断标准的75g葡萄糖耐量试验(OGTT),对试验阴性者的不良反应、剖宫产率、胎儿窘迫、胎膜早破、妊娠期高血压疾病、羊水过多、产后出血的发生率及新生儿窒息、畸形、早产儿、巨大儿的发生率等资料进行分析。结果 GST组阴性为81.67%,OGTT组阴性为79.00%。两组孕妇剖宫产率、胎儿窘迫、胎膜早破、妊娠期高血压疾病、羊水过多、产后出血的发生率及新生儿窒息、畸形、早产儿、巨大儿的发生率比较差异均不显著,而OGTT组服糖后不良反应大于GST组,(x^2=7.0015,P<0.05)。结论如果以糖耐量异常为干预点,则两种诊断标准阴性者围产期结局无显著性差异;但采用IADPSG诊断标准进行OGTT试验会增加孕妇服糖的不良反应,依从性低,且增加了医院检验科的工作量,在我国县镇医院,推广需谨慎。Objective To investigate different screening methods for gestational diabetes mellitus （GDM） and pregnancy outcomes. Methods Totally 600 pregnant women were divided into two groups, which separately tested by 50g glucose screening test （ GST group） and 75g oral glucose tolerance test by International Association of Diabetes and Pregnancy Study Groups （IADPSG） （OGTT group）. The adverse reactions, cesarean section rate, fetal distress, premature rupture of membranes, hypertensive disorders in pregnancy, polyhydramnios, incidence of postpartum hemorrhage, incidence of neonatal asphyxia, malformation, premature infant and macrosomia of pregnant women with negative results were analyzed. Results The negative rate in GST group was 81.67%, but in OGTT group it was 79.00%. There was no obvious difference in the incidence rate between two groups. The pregnant women showed more adverse reactions in OGTY group than in GST group （X2 = 7. 0015, P 〈 0.05 ）. Conclusion If impaired glucose tolerance （IGT） is selected as intervention point, women with negative results show no obvious differences by two diagnostic criteria. Pregnant women will show more adverse reactions after taking glucose if tested by OGTI＇ and diagnosed by IADPSG, which also increases hospital laboratory work. So we should be prudent in populating this way in county hospitals in China.

关 键 词：妊娠期糖尿病 糖筛查试验 葡萄糖耐量试验 不良反应 妊娠结局 

分 类 号：R714.25[医药卫生—妇产科学]