孕中期血糖水平与不良妊娠结局的关系研究  

Study of the relationship between second trimester materal blood glucose levels and adverse pregnancy outcomes

作　　者：闵洁[1] 陈璐璐[1] 胡帝[1] 曾天舒[1] 廖云飞[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院内分泌科,武汉430022

出　　处：《中国医学前沿杂志（电子版）》2015年第8期24-28,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：十一五国家科技支撑计划项目(2009BAI80B00)

摘　　要：目的探讨孕中期血糖水平与不良妊娠结局的关系。方法回顾性分析2010年8月至2011年1月孕24周起于湖北省妇幼保健院产科行50 g葡萄糖负荷试验(glucose challenge test,GCT)的693例单胎自然受孕孕妇的临床资料,检测孕晚期孕妇空腹血糖(FBG)、空腹血清胰岛素、分娩后即刻脐血血糖及脐血胰岛素水平。分析孕中期50 g GCT血糖水平与不良妊娠结局的关系。结果 50 g GCT血糖水平分组:剖宫产的发生率随孕妇血糖水平升高而逐渐下降(P=0.000)。随孕妇血糖水平升高,妊娠高血压、剖宫产、早产及大于胎龄儿(LGA)的发生无固定优势趋势。但从第3组开始,患妊娠高血压的可能性递增,早产发生的可能性也呈递增趋势,剖宫产发生的可能性呈递减趋势,而第4组LGA发生率最高。FBG水平分组:剖宫产和早产的发生率在不同血糖水平中差异具有显著性。剖宫产发生的可能性随FBG的升高而递减,从第3组开始,患妊娠高血压的可能性递增,早产发生的可能性亦递增,而第5组LGA发生率最高。孕中期50 g GCT血糖水平与母亲胰岛素、脐血胰岛素、脐血血糖均无明显相关性(P>0.05),孕晚期FBG水平与母亲胰岛素、脐血胰岛素、脐血血糖的偏相关系数分别为0.402、0.080、0.159。按孕晚期FBG分组,母亲胰岛素及脐血胰岛素水平呈明显上升趋势(P<0.05)。结论在一定血糖范围内,LGA发生的可能性随孕中期50 g GCT血糖升高而升高。而随着孕期血糖升高,妊娠高血压及早产发生的可能性呈相似变化,剖宫产发生的可能性降低。Objective To investigate the relationship between second trimester blood glucose levels and adverse pregnancy outcomes. Method The clinical data of 693 pregnant women who underwent the 50 g glucose challenge test(GCT) from August 2010 to January 2011 in Maternal and Child Health Hospital of Hubei Province were collected. Detected the third trimester pregnant women with fasting blood glucose(FBG), fasting serum insulin, the blood glucose and insulin of umbilical cord blood. The relationship between adverse pregnancy outcomes and the blood glucose levels of 50 g GCT was analyzed. Result 50 g GCT blood glucose levels: The incidence of cesarean section was gradually decreased with the increase of blood glucose level of pregnant women(P = 0.000). With the increase of blood glucose level, there was no fixed advantage for the occurrence of gestational hypertension, cesarean section, premature delivery and LGA. But from the third group, the possibility of the gestational hypertension of pregnant was gradually decreased, as well as the possibility of premature delivery, while the occurrence of cesarean delivery was decreased. The incidence of LGA was highest in the fourth group. There was the significant difference in the incidence of cesarean section and premature delivery at different blood glucose levels. The possibility of cesarean section was decreased with the increase of FBG. From the third group, the possibility of gestational hypertension was gradually increased; the possibility of premature delivery was also increased, with the highest incidence of LGA in the fifth group. FBG level group: There was significant difference in the incidence of cesarean section and premature delivery in different blood glucose levels. The probability of occurrence of cesarean section decreased with the increased of FBG. From the third group, the possibility of the gestational hypertension was gradually decreased, as well as the possibility of premature delivery. The incidence of LGA was highest in the fifth group. There was no signi

关 键 词：孕中期 血糖 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]