乙型肝炎病毒感染对妊娠期糖尿病孕妇及新生儿的影响  

Effection of hepatitis B virus infection on pregnant woman with gestational diabetes mellitus and their newborn

作　　者：伊诺[1] 姜秀娟[1] 梁东竹[1] 刘敏[1] 许艳丽[1] 许仲婷[1] 周明书[1] 付丽华[1] 

机构地区：[1]首都医科大学附属北京地坛医院妇产科,北京100015

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第2期93-96,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：首都临床特色应用研究资助(No.Z121107001012030)

摘　　要：目的探讨乙型肝炎病毒(HBV)感染对妊娠期糖尿病(GDM)发生率、孕妇妊娠结局以及所娩新生儿的影响。方法分析2011年1月1日~2014年10月31日于本院产前检查并分娩的6311例HBV感染孕妇病历资料。根据孕妇肝功能情况分为A、B两组。A组患者(肝功能正常,慢性HBV携带或非活动HBsAg携带)5264例,B组患者(肝功能异常,慢性乙型肝炎)1047例。比较两组孕妇年龄和GDM发病率。比较两组中确诊GDM孕妇的妊娠和分娩情况以及所分娩新生儿的体重、窒息和畸形情况。结果 A组孕妇年龄(29.08±4.29)岁,B组孕妇年龄(29.73±3.61)岁,差异具有统计学意义(t=4.589、P<0.001)。两组病例中诊断为GDM孕妇共1 906例,其中A组孕妇GDM发病率为1548/5 264(29.41%),B组孕妇GDM发病率为358/1047(34.19%),差异具有统计学意义(x^2=9.488、P=0.002)。对肝功能和年龄因素进行Logistic回归分析,提示肝功能和年龄是GDM发病的高风险因素(P=0.009、<0.001)。两组GDM孕妇的年龄、早产情况、合并妊娠期高血压疾病、胎儿宫内窘迫和剖宫产情况,差异均具有统计学意义(t=2.683、x^2=15.930、4.613、22.114和38.992;P=0.007、0.000、0.032、0.000和0.000)。两组GDM孕妇的羊水情况、胎儿宫内发育受限、死胎/死产、胎膜早破、助产和产后出血情况差异均无统计学意义。两组GDM孕妇所娩新生儿的体重和窒息情况差异具有统计学意义(t=3.988、P<0.0001,x^2=4.923、P=0.027)。新生儿畸形情况差异无统计学意义。结论肝功能状态和年龄是GDM发生的高风险因素。HBV感染孕妇肝功能异常增加了GDM的发病率,增加了早产、合并妊娠期高血压疾病、胎儿宫内窘迫、剖宫产、分娩巨大儿和低体重儿的几率,亦增加了新生儿窒息的几率。监测HBV感染GDM孕妇肝功能并维持其基本正常,有助于减少不良妊娠结局。Objective To study the effect of hepatitis B virus（HBV） infection on gestational diabetes mellitus（GDM） incidence and the outcomes of pregnant woman and their newborn.Methods Pregnant women with HBV infection of 6 311 cases were analyzed,retrospectively.They had done their prenatal examination and delivery in the Department of Obstetrics and Gynecology,Beijing Ditan Hospital,Capital Medical University during 1 st January 2011 to 31 st October 2014.They 6 311 cases were divided into two groups according to their liver function.Group A（with nomal liver function,chronic HBV carriers or inactive HBsAg carriers） with 5 264 cases and group B（with abnomal liver function,chronic hepatitis B） with1 047 cases.The GDM incidence and the age of women in two groups were compared.And,the pregnancy and childbirth of women diagnosed GDM in two groups were compared.The weight,asphyxia and deformity of their newborn were also compared.Results The average age in group A was（29.08 ± 4.29）.The average age in group B was（29.73±3.61）.The difference were statistically significant in two groups（t= 4.589,P0.001）.Total of 1 906 pregnant women were diagnosed as GDM,which 1548 in group A and 358 in group B.The incidence of GDM in two groups were 29.41%（1548/5264） and 34.19%（358/1047）,respectively.The difference of GDM incidence were significantly different in the two groups（x^2=9.488,P= 0.002）.The liver function and age were risk factors for GDM through analysis of Logistic regression（P=0.009）.There were significant differences in age,preterm birth,gestational hypertension disease,fetal intrauterine distress and cesarean delivery of pregnant women with GDM in the two groups（t=2.683,x^2=15.930,4.613,22.114 and 38.992;P=0.007,0.000,0.032,0.000 and 0.000）.There were no significant differences in amniotic fluid,fetal intrauterine growth restriction,stillbirth/stillbirth,premature rupture of membranes,midwifery and postpartum hemorrhage of pregnant women with GDM in the two groups.There were signif

关 键 词：肝炎病毒 乙型 妊娠期糖尿病 孕妇 新生儿 

分 类 号：R714.256[医药卫生—妇产科学]